Compositions and method of treating cancer

ABSTRACT

The disclosure provides for compounds of the general structure: 
                         
and methods of using and compositions comprising the compounds for treating infections, cancer and neoplastic diseases and disorders.

CROSS REFERENCE TO RELATED APPLICATIONS

This application is a U.S. National Stage Application filed under 35 U.S.C. § 371 and claims priority to International Application No. PCT/US2018/024511, filed Mar. 27, 2018, which claims priority under 35 U.S.C. § 119 from Provisional Application Ser. No. 62/477,370, filed Mar. 27, 2017, and from Provisional Application Ser. No. 62/638,058, filed Mar. 2, 2018, the disclosures of which are incorporated herein by reference.

STATEMENT REGARDING FEDERALLY SPONSORED RESEARCH

This invention was made with Government support under Grant No. AI083358, awarded by the National Institutes of Health. The Government has certain rights in the invention.

TECHNICAL FIELD

The disclosure relates to anti-cancer agents, methods of making, and methods of use thereof.

INCORPORATION BY REFERENCE OF SEQUENCE LISTING

Accompanying this filing is a Sequence Listing entitled “Sequence_ST25.txt”, created on Mar. 26, 2018 and having 98,239 bytes of data, machine formatted on IBM-PC, MS-Windows operating system. The sequence listing is hereby incorporated herein by reference in its entirety for all purposes.

Microrganism Deposit

Exemplary microorganisms of the disclosure (Staphylococcus epidermidis MO34 and Staphylococcus epidermidis MO38) were deposited on Mar. 22, 2018 with the American Type Culture Collection, 10801 University Boulevard, Manassas, Va. 20110-2209, as ATCC Number PTA-125026 (strain designation S.epi-MO38 UCSD 20180315) and as ATCC Number PTA-125025 (strain designation S.epi-MO34 UCSD 20180315) under the Budapest Treaty. This deposit will be maintained at an authorized depository and replaced in the event of mutation, nonviability or destruction for a period of at least five years after the most recent request for release of a sample was received by the depository, for a period of at least thirty years after the date of the deposit, or during the enforceable life of the related patent, whichever period is longest. All restrictions on the availability to the public of these cell lines will be irrevocably removed upon the issuance of a patent from the application.

BACKGROUND

It is estimated that in 2017 there will be over 1.5 million new cancer cases diagnosed and greater than 600,000 cancer deaths in the U.S. Although advances have been made to treat and prevent various cancers, new methods and compositions are need.

SUMMARY

The disclosure provides compositions and methods useful for the treatment of neoplasias and cancers.

In a particular embodiment, the disclosure provides for a compound having the general formula of Formula I(a):

or a pharmaceutically acceptable salt or prodrug thereof, wherein, N¹-N⁵ are nitrogen atoms; X¹-X² are carbon atoms; the R groups attached by a dashed line are present, or are not present if the R group is connected to an atom that is bound to another atom by a double covalent bond; the bond indicated by both a straight line and a dashed line indicate that the bond may be a single covalent bond or a double covalent bond; the fused heterocyclic ring system comprises three double bonds with N² or N³ forming a double bond and with X¹, and with N⁴ or N⁵ forming a double bond with X²; R¹ is a hydroxyl, ester, carboxylic acid, or —O—R¹⁰; R², R⁴, R⁵, R⁷-R⁹ are independently a H, D, optionally substituted (C₁-C₆)-alkyl, optionally substituted (C₁-C₆)-alkenyl, optionally substituted (C₁-C₆)-alkynyl, optionally substituted (C₃-C₁₂)cycloalkyl, optionally substituted (C₄-C₁₂)cycloalkenyl, optionally substituted aryl; R³ and R⁶ are independently selected from a H, D, optionally substituted (C₁-C₆)-alkyl, optionally substituted (C₁-C₆)-heteroalkyl, optionally substituted (C₁-C₆)-alkenyl, optionally substituted (C₁-C₆)-heteroalkenyl, optionally substituted (C₁-C₆)-alkynyl, optionally substituted (C₁-C₆)-heteroalkynyl, optionally substituted (C₃-C₁₂)cycloalkyl, optionally substituted (C₄-C₁₂)cycloalkenyl, optionally substituted aryl, optionally substituted heterocycle, halide, hydroxyl, carbonyl, aldehyde, carboxyl, ester, alkoxy, carboxyamide, amine, imine, azide, cyano, nitro, nitroso, thiol, sulfide, sulfoxide, sulfone, and phosphate; R¹⁰ is selected from D, optionally substituted (C₁-C₆)-alkyl, optionally substituted (C₁-C₆)-heteroalkyl, optionally substituted (C₁-C₆)-alkenyl, optionally substituted (C₁-C₆)-heteroalkenyl, optionally substituted (C₁-C₆)-alkynyl, optionally substituted (C₁-C₆)-heteroalkynyl, optionally substituted (C₃-C₁₂)cycloalkyl, optionally substituted (C₄-C₁₂)cycloalkenyl, optionally substituted aryl, and optionally substituted heterocycle.

In another embodiment, the disclosure provides a compound having the general formula of Formula I(b):

or a pharmaceutically acceptable salt or prodrug thereof, wherein, N¹-N⁵ are nitrogen atoms; X¹—X² are carbon atoms; the R groups attached by a dashed line are present, or are not present if the R group is connected to an atom that is bound to another atom by a double covalent bond; the bond indicated by both a straight line and a dashed line indicate that the bond may be a single covalent bond or a double covalent bond; the fused heterocyclic ring system comprises three double bonds with N² or N³ forming a double bond with X¹, and with N⁴ or N⁵ forming a double bond with X²; R¹ is a hydroxyl, ester, carboxylic acid, or —O—R¹⁰; R², R⁴, R⁵, and R⁷ are independently a H, D, optionally substituted (C₁-C₆)-alkyl, optionally substituted (C₁-C₆)-alkenyl, optionally substituted (C₁-C₆)-alkynyl, optionally substituted (C₃-C₁₂)cycloalkyl, optionally substituted (C₄-C₁₂)cycloalkenyl, optionally substituted aryl; R¹⁰ is selected from D, optionally substituted (C₁-C₆)-alkyl, optionally substituted (C₁-C₆)-heteroalkyl, optionally substituted (C₁-C₆)-alkenyl, optionally substituted (C₁-C₆)-heteroalkenyl, optionally substituted (C₁-C₆)-alkynyl, optionally substituted (C₁-C₆)-heteroalkynyl, optionally substituted (C₃-C₁₂)cycloalkyl, optionally substituted (C₄-C₁₂)cycloalkenyl, optionally substituted aryl, and optionally substituted heterocycle.

In yet another embodiment, the disclosure provides a compound of general formula II (6-N-hydroxyaminopurine (6-HAP)):

or a pharmaceutically acceptable salt or prodrug thereof; or a tautomer of the compound of Formula II, or a pharmaceutically acceptable salt or prodrug of the tautomer of compound of Formula II thereof.

In another embodiment, the disclosure provides a pharmaceutical composition comprising a compound of formula I(a), I(b) and/or II and a pharmaceutically acceptable carrier. In yet another embodiment, the pharmaceutical composition comprises at least one additional active agent. In still a further embodiment, the at least one additional active agent is a chemotherapeutic agent. If still a further embodiment, the chemotherapeutic agent is selected from the group consisting of an alkalating agent, an antimetabolite, an anti-microtubule agent, a topoisomerase inhibitor, and a cytotoxic antibiotic. In a further embodiment, the anticancer agent is selected from the group consisting of cisplatin (CDDP), carboplatin, procarbazine, mechlorethamine, cyclophosphamide, camptothecin, ifosfamide, melphalan, chlorambucil, busulfan, nitrosourea, dactinomycin, daunorubicin, doxorubicin, bleomycin, plicamycin, mitomycin, etoposide (VP16), tamoxifen, raloxifene, estrogen receptor binding agents, docetaxel, paclitaxel, gemcitabine, navelbine, farnesyl-protein transferase inhibitors, transplatinum, 5-fluorouracil, vincristine, vinblastine, 6-mercaptopurine; capecitabine; cladribine; clorfarabine; cytarabine; doxorubicin; fludarabine; floxuridine; gemcitabine; hydroxyurea; methotrexate; pemetrexed; pentostatin; prednisone; procarbazineand methotrexate, or any analog or derivative variant thereof.

The disclosure also provides a method of treating a neoplasm (including precancerous), cell proliferative disorder or cancer comprising contacting a subject topically or parenterally with a compound or pharmaceutical composition containing the compound of Formula I(a), I(b) and/or II in an amount effective to treat the neoplasm, cancer or cell proliferative disorder.

S. epidermidis produces 6-HAP, which was found to inhibit DNA synthesis and has the potential to convey protection against neoplasia. A beneficial role for skin bacteria in host defense is consistent with observations of a role for commensal bacteria to resist S. aureus infection, but further extends this concept to host defense functions against cancer and pre-cancerous neoplasms, e.g., papillomas and actinic keratosis). Moreover, a loss of S. epidermidis strains that produce 6-HAP may increase a subject's risk for developing skin cancer. As such the disclosure provides for probiotic compositions which comprise an S. epidermidis strains that produces 6-HAP for preventing, attenuating and/or inhibiting neoplasia in a subject.

In a particular embodiment, the disclosure provides for a composition that protects a subject from skin cancer or other type of neoplasia, comprising (i) a composition of formulat I, II or II and/or (ii) a probiotic commensal microorganism that produces 6-N-hydroxyaminopurine (6-HAP). In a further embodiment, the probiotic commensal microorganism is a strain of Staphylococcus epidermis. In yet a further embodiment, the strain is one or more of Staphylococcus epidermis is Staphylococcus epidermis MO34 and/or Staphylococcus epidermis MO38. In another embodiment, the composition is formulated for topical or dermal delivery. In yet another embodiment, the composition is in the form of a lotion, shake lotion, cream, ointment, gel, foam, powder, solid, paste or tincture. In a further embodiment, the composition further comprises one or more sunscreen agents. Examples of sunscreen agents include, but are not limited to, aminobenzoic acid, avobenzone, cinoxate, dioxybenzone, ecamsule, ensulizole, homosalate, meradimate, octocrylene, octinoxate, octisalate, oxybenzone, padimate O, sulisobenzone, titanium dioxide, trolamine salicylate, and zinc oxide. In yet a further embodiment, the skin protectant composition further comprises one or more topical antibiotics. Examples of topical antiboitics include, but are not limited to, sulfacetamide sodium, bacitracin, polymyxin b, erythromycin, silver sulfadiazine, neomycin, retapamulin, and mupirocin.

In a certain embodiment, the disclosure further provides for a method of preventing a subject from developing skin cancer or other type of neoplasia, comprising topically administering to the subject a composition of the disclosure. In a further embodiment, the neoplasia is an epithelial neoplasia. In yet a further embodiment, the neoplasia is induced by or from UV exposure.

BRIEF DESCRIPTION OF THE DRAWINGS

FIG. 1A-D shows S. epidermidis strains isolated from normal human skin produce non-proteinaceous molecule with antimicrobial activity. (a) Screening for antimicrobial activity of culture supernatant from 44 strains of S. epidermidis strains isolated from normal human skin by radial diffusion assay against gropu A streptococcus (GAS). Data represent diameter of growth inhibition zone of conditioned media of each strain. UD=undetectable. (b) Elution profile of the antimicrobial compound purified from culture supernatant of S. epidermidis MO34 by HPLC using a PolyHYDROXYMETHYL. The last step of 5 purification steps is shown. The insert panel represents antimicrobial activity of each fraction on radial diffusion assay against GAS. Green line represents a gradient of H₂O in acetonitrile. (c-d) Stability of antimicrobial molecules from S. epidermidis producing the strongest antibiotic activity (MO34) against GAS after heat-treatment (100° C. for indicated time) (c) and incubation with proteinase K (2 mg/mL) or papain (2 mg/mL) at 37° C. for 3 hrs, followed by 5-min incubation at 90° C. to inactivate enzyme (d). Antimicrobial activity against GAS was determined by radial diffusion assay.

FIG. 2A-B shows colonization by S. epidermidis strain producing 6-HAP enhances antimicrobial activity against pathogenic bacteria on skin surface. (a-b) Antimicrobial activity of mouse skin colonized by either S. epidermidis producing 6-HAP (MO34), a non-antimicrobial strain (ATCC1457), or vehicle against GAS or methicillin resistant Staphylococcus aureus (MRSA) challenge. Mouse dorsal skin was applied with S. epidermidis (MO34 or ATCC1457) or PBS (vehicle) for 2 hrs. Pathogens were then applied to the skin surface for 6 hrs. Bacterial survival was measured by swabbing and counting serial dilutions of the swab sample plated on a blood agar plate for GAS (hemolytic) and S. epidermidis (non-hemolytic) or a mannitol salt agar with egg yolk for MRSA (mannitol positive: a large yellow colony with egg yolk reaction) and S. epidermidis (mannitol negative: a small pink colony without egg yolk reaction). Each dot represents data from an individual mouse. *P<0.05 and **P<0.01 by Student's t-test.

FIG. 3A-G shows S. epidermidis strains produce 6-N-hydroxyaminopurine with antimicrobial activity. (a) Molecular mass of purified antibiotic from S. epidermidis MO34 strain analyzed by high-resolution electron spray ionization mass spectrometry. (b) ¹⁵N isotope incorporation into the antibiotic molecule after culturing S. epidermidis MO34 in TSB containing ammonium-¹⁵N chloride (12.5 mM) for 24 hrs. (c-d) Comparison of chemical shifts of purified antibiotic (c) with those of synthetic 6-HAP (d) in ¹H-NMR. (e-f) Comparison of the fragmentation profile of purified antibiotic (e) with that of synthetic 6-HAP (f) on electron-impact mass spectrometry. (g) The determined chemical structure of the antibiotic (6-HAP).

FIG. 4A-G shows 6-HAP is a direct inhibitor of DNA polymerization. (a) Time course killing of GAS in THB containing 6-HAP (25 μg/mL), mitomycin C (5 μg/mL), or LL-37 (10 μM). At each indicated time point, live GAS in the media was measured by counting CFU on an agar plate. The data represent mean±SE of four individual experiments. (b) Membrane permeability of GAS incubated in THB containing 6-HAP (25 μg/mL), mitomycin C (5 μg/mL) and LL-37 (10 μM) for 1 hr. The bacteria with compromised plasma membranes (Red) can be distinguished from those with intact membranes (Green). (c) BrdU incorporation into nascent DNA of GAS after incubation with 6-HAP (25 μg/mL) or mitomycin C (5 μg/mL) in THB containing BrdU (10 μM) for 30 or 60 min. (d) BrdU incorporation into nascent DNA of S. epidermidis ATCC12228 after incubation with 6-HAP (25 μg/mL) or mitomycin C (5 μg/mL) in THB containing BrdU (10 μM) for 60 min. The data represent mean±SE of five individual experiments (*P<0.05 and **P<0.01 by Student's t-test vs vehicle control). (e-f) Capacity of 6-HAP to block in vitro DNA extension by Klenow fragment polymerase. Extension reaction was carried out with IRDye800-labeled 18-nt primer (SEQ ID NO:57) and 25-nt template which required adenosine (X=T) or cytidine (X=G) at the initial base for extension (SEQ ID NO:58) (e). Extension reaction was analyzed on a 20% acrylamide gel by electrophoresis (f). (g) Antimicrobial activity of 6-HAP against GAS in the presence of adenine. GAS was incubated in media containing 6-HAP with or without adenine for 20 hrs. GAS survival was measured by counting CFU. The data represent mean±SE of four individual experiments (**P<0.01 by Student's t-test).

FIG. 5A-E shows mARC2 responsible for selective anti-proliferative activity of 6-HAP. (a-b) Selective antiproliferative activity of 6-HAP against Pam212 squamous cell carcinoma, but not against normal keratinocytes. BrdU incorporation into Pam212 cells (b) or NHEKs (b) after 4-hr or 24-hr incubation, respectively, in suitable media containing indicated concentrations of 6-HAP or mitomycin C (10 μg/mL) (a). (c) Expression of mARC1 and mARC2 in NHEKs, squamous cell carcinoma (Pam212), melanoma (B16F10) and lymphoma cell lines (L5178). To compare relative expression level in each cells, data was shown as relative to GAPDH expression. (d) Expression of mARC1 and mARC2 in NHEKs treated with control siRNA, mARC1 siRNA and mARC2 siRNA. (e) Effect of gene silencing with mARC1 and mARC2 siRNA on sensitivity to 6-HAP in NHEKs. NHEKs treated with each siRNA were incubated for 48 hrs and then incubated with 10 ng/mL of 6-HAP for 24 hrs.

FIG. 6A-E shows 6-HAP improves deep skin infection and slows growth of B16 melanoma in mice. (a-c) Effect of a single intravascular injection of 6-HAP on skin infection by GAS. The size of the infected lesion was measured by Image-J software (a). Representative images of infected skin (arrow) of mouse treated with 6-HAP or vehicle at Day-1 and Day-3 post infection are shown in (b). Infected skin was removed 24 and 72 hrs after bacterial injection and homogenized in PBS (c). CFUs were enumerated by plating serial dilutions of the homogenate on an agar plate. The data represent mean±SE of eight individual experiments (*P<0.05 and **P<0.01 by Student's t-test vs vehicle control). (d-e) Effect of repeated intravascular administrations with 6-HAP on growth of melanoma in mice. The data represent mean±SE of 10 individual experiments (*P<0.05, **P<0.01 and ***P<0.001 by Student's t-test vs vehicle control) (d). Representative images of tumor (broken line) in mouse treated with 6-HAP or vehicle at Day-9 and Day-13 are shown in (e).

FIG. 7A-H shows S. epidermidis strains producing 6-N-hydroxyaminopurine suppress UV-induced skin tumor formation in SKH-1 hairless mice. (a-d) Effect of colonization by S. epidermidis MO34 producing 6-HAP on tumor incidence (a) and number (b) in SKH-1 hairless mice treated with DMBA, followed by UV-B irradiation at 180 mJ/cm² twice a week. S. epidermidis ATCC1457 was used as a control strain that does not produce 6-HAP. Tumor incidence and tumor number in each mouse were recoded every week. The data represent mean±SE of 19 mice. Representative images of UV-induced tumor formation in mouse treated with S. epidermidis ATCC1457 (c) or MO34 (d) at week-12 are shown. (e-f) A representative H&E staining of UV-induced skin tumor or skin obtained from SKH-1 mice colonized by S. epidermidis 1457 (e) or MO34 (f), respectively, treated with UV-B for 12 weeks. (g-h) Immunostaining for S. epidermidis and keratin-14 in the UV-induced tumor or skin of SKH-1 mice treated with S. epidermidis ATCC1457 (g) or MO34 (h), respectively.

FIG. 8A-D shows Productions of 6-HAP by skin isolate strains and laboratory strains of S. epidermidis. (a-d) MO34 (a) and MO38 (b) strains of S. epidermidis isolated from the surface of normal human skin, or ATCC12228 (c) and ATCC1457 (d) laboratory strains were cultured overnight in TSB. 6-HAP was partially purified from culture supernatant according to the Method section. Left panel shows a HPLC-elution profile of 6-HAP (Arrow) on a TSKgel NH2-100 amino column (4.6×150 mm) (Tosoh Biosci. LLC, Tokyo, Japan) after Sep-Pak step (See method). The elution profile was monitored at 270 nm. Green line represents a gradient of H₂O in acetonitrile. The right panel represents antimicrobial activity of each fraction on radial diffusion assay against GAS.

FIG. 9 shows the gHMBC Spectrum (500 MHz) of 6-HAP in AcOD-D2O. The carbon spectrum of 6-HAP was measured indirectly by the gHMBC experiment. The gHMBC spectral data was recorded on a Mercury Pluss 500 (Varian) spectrometer. FID file was processed using MestRenova 8.1 (MestreLab Research). The gHMBC spectrum of 6-HAP in AcOD-D2O (1:5 v/v) revealed five carbon signals in the aromatic region (δC=113.60, 144.94, 148.17, 150.28, 150.45).

FIG. 10 shows a comparison of antimicrobial activity of natural 6-HAP and synthetic 6-HAP. GAS (1×10⁵ CFU/mL) were incubated with indicated concentrations of purified 6-HAP or synthetic 6-HAP in THB overnight. Bacterial growth was monitored by measuring OD600 (relative % of growth index).

FIG. 11 shows the capacity of 6-HAP to directly disrupt plasma membrane of human keratinocytes and sebocytes. Normal human epidermal keratinocytes (NHEKs) or immortalized human sebocyte cell line (SZ95) (1×10⁵ cells) were incubated with the indicated concentrations of 6-HAP in Epilife or Sebmed medium, respectively, at 37° C. for 6 hrs. Vehicle (0.5% DMSO) or Triton X-100 (0.1%) was added to achieve 0% or 100% of LDH release, respectively. LDH release was determined with Cytotoxicity Detection Kit (LDH) (Roche, Mannheim, Germany) according to the protocol provided. Data represent mean±SE of three individual experiments.

FIG. 12A-C shows 6-HAP exerts antiproliferative activity against tumor cell lines. Proliferative activity of tumor cell line, L5178 (a), YAC-1 lymphoma (b), B16F10 melanoma (c) after 4-hr incubation in suitable media containing indicated concentrations of 6-HAP or mitomycin C (10 μg/mL). Proliferative activity of cells was determined by monitoring BrdU incorporation. The data represent mean±SE of four individual experiments.

FIG. 13 shows Systemic toxicity of 6-HAP in mice. C57BL6 mice (8 week female) were intravascularly administrated with 6-HAP (20 mg/kg) or with an equal volume of vehicle (2.5% DMSO in 0.9% NaCl) every 48 hours for 2 weeks (Arrows). To observe toxicity of 6-HAP, mouse weight was determined at indicated time points. Data represent mean±SE of 10 mice.

DETAILED DESCRIPTION

As used herein and in the appended claims, the singular forms “a,” “an,” and “the” include plural referents unless the context clearly dictates otherwise. Thus, for example, reference to “a compound” includes a plurality of such compounds and reference to “the cell” includes reference to one or more cells and so forth.

Unless defined otherwise, all technical and scientific terms used herein have the same meaning as commonly understood to one of ordinary skill in the art to which this disclosure belongs. Although any methods and reagents similar or equivalent to those described herein can be used in the practice of the disclosed methods and compositions, the exemplary methods and materials are now described.

Also, the use of “or” means “and/or” unless stated otherwise. Similarly, “comprise,” “comprises,” “comprising” “include,” “includes,” “including,” “have,” “haves,” and “having” are interchangeable and not intended to be limiting.

It is to be further understood that where descriptions of various embodiments use the term “comprising,” those skilled in the art would understand that in some specific instances, an embodiment can be alternatively described using language “consisting essentially of” or “consisting of.”

All publications mentioned herein are incorporated herein by reference in full for the purpose of describing and disclosing the methodologies, which are described in the publications, which might be used in connection with the description herein. However, with respect to any similar or identical terms found in both the incorporated publications or references and those expressly put forth or defined in this application, then those terms definitions or meanings expressly put forth in this application shall control in all respects. The publications discussed above and throughout the text are provided solely for their disclosure prior to the filing date of the present application. Nothing herein is to be construed as an admission that the inventors are not entitled to antedate such disclosure by virtue of prior disclosure.

The term “alkyl”, refers to an organic group that is comprised of carbon and hydrogen atoms that contains single covalent bonds between the carbons. Generally, an “alkyl” as used in this disclosure, refers to an organic group that contains 1 to 20 carbon atoms, unless stated otherwise. Wherein if there is more than 1 carbon, the carbons may be connected in a linear manner, or alternatively if there are more than 2 carbons then the carbons may also be linked in a branched fashion so that the parent chain contains one or more secondary, tertiary, or quaternary carbons. An alkyl may be substituted or unsubstituted, unless stated otherwise. Substituted alkyl groups include among others those which are substituted with aryl groups, which in turn can be optionally substituted. Specific alkyl groups include methyl, ethyl, n-propyl, iso-propyl, cyclopropyl, n-butyl, s-butyl, t-butyl, cyclobutyl, n-pentyl, branched-pentyl, cyclopentyl, n-hexyl, branched hexyl, and cyclohexyl groups, all of which are optionally substituted. Specific substituted alkyl groups include haloalkyl groups, particularly trihalomethyl groups and specifically trifluoromethyl groups.

The term “alkenyl”, refers to an organic group that is comprised of carbon and hydrogen atoms that contains at least one double covalent bond between two carbons. Generally, an “alkenyl” as used in this disclosure, refers to organic group that contains 1 to 20 carbon atoms, unless stated otherwise. While a C₁-alkenyl can form a double bond to an atom of a parent chain, an alkenyl group of three or more carbons can contain more than one double bond. It certain instances the alkenyl group will be conjugated, in other cases an alkenyl group will not be conjugated, and yet other cases the alkenyl group may have stretches of conjugation and stretches of nonconjugation. Additionally, if there is more than 1 carbon, the carbons may be connected in a linear manner, or alternatively if there are more than 3 carbons then the carbons may also be linked in a branched fashion so that the parent chain contains one or more secondary, tertiary, or quaternary carbons. An alkenyl may be substituted or unsubstituted, unless stated otherwise. Substituted alkenyl groups include among others those which are substituted with alkyl or aryl groups, which groups in turn can be optionally substituted. Specific alkenyl groups include ethenyl, prop-1-enyl, prop-2-enyl, but-1-enyl, but-2-enyl, pent-1-enyl, pent-2-enyl, branched pentenyl, hex-1-enyl, branched hexenyl, all of which are optionally substituted.

The term “alkynyl”, refers to an organic group that is comprised of carbon and hydrogen atoms that contains a triple covalent bond between two carbons. Generally, an “alkynyl” as used in this disclosure, refers to organic group that contains 1 to 20 carbon atoms, unless stated otherwise. While a C₁-alkynyl can form a triple bond to an atom of a parent chain, an alkynyl group of three or more carbons can contain more than one triple bond. Where if there is more than 1 carbon, the carbons may be connected in a linear manner, or alternatively if there are more than 4 carbons then the carbons may also be linked in a branched fashion so that the parent chain contains one or more secondary, tertiary, or quaternary carbons. An alkynyl may be substituted or unsubstituted, unless stated otherwise.

The term “antimicrobial” as it relates to treatments, agents, and compounds refers to an agent that can be used to suppress, attenuate, ameliorate, any symptom caused by or resulting from an infection by a foreign agent. For the purposes of this disclosure a foreign agent includes, but is not limited to, bacteria, parasites, viruses, and fungi.

The term “anticancer” as it relates to treatments, agents, and compounds refers to an agent (e.g., small molecule such as 6-HAP or a probiotic) that can be used to suppress, attenuate, ameliorate, any symptom caused by or resulting from a cell proliferative disorder, neoplasm or cancer.

The term “aryl”, as used in this disclosure, refers to a conjugated planar ring system with delocalized pi electron clouds that contain only carbon as ring atoms. An “aryl” for the purposes of this disclosure encompass from 1 to 7 aryl rings wherein when the aryl is greater than 1 ring the aryl rings are joined so that they are linked, fused, or a combination thereof. An aryl may be substituted or unsubstituted, or in the case of more than one aryl ring, one or more rings may be unsubstituted, one or more rings may be substituted, or a combination thereof. Substituted aryl groups include among others those which are substituted with alkyl or alkenyl groups, which groups in turn can be optionally substituted. Specific substituted aryl groups include mono-, di-, tri, tetra- and pentahalo-substituted phenyl groups; mono-, di-, tri-, tetra-, penta-, hexa-, and hepta-halo-substituted naphthalene groups; 3- or 4-halo-substituted phenyl groups, 3- or 4-alkyl-substituted phenyl groups, 3- or 4-alkoxy-substituted phenyl groups, 3- or 4-RCO-substituted phenyl, 5- or 6-halo-substituted naphthalene groups. More specifically, substituted aryl groups include acetylphenyl groups, particularly 4-acetylphenyl groups; fluorophenyl groups, particularly 3-fluorophenyl and 4-fluorophenyl groups; chlorophenyl groups, particularly 3-chlorophenyl and 4-chlorophenyl groups; methylphenyl groups, particularly 4-methylphenyl groups, and methoxyphenyl groups, particularly 4-methoxyphenyl groups. Specific aryl groups include phenyl groups, biphenyl groups, and naphthyl groups, all of which are optionally substituted.

For purposes of the disclosure the term “cancer” will be used to encompass cell proliferative disorders, neoplasms, precancerous cell disorders and cancers. Thus, a “cancer” refers to any cell that undergoes aberrant cell proliferation that can lead to metastasis or tumor growth. Exemplary cancers include but are not limited to, adrenocortical carcinoma, AIDS-related cancers, AIDS-related lymphoma, anal cancer, anorectal cancer, cancer of the anal canal, appendix cancer, childhood cerebellar astrocytoma, childhood cerebral astrocytoma, basal cell carcinoma, skin cancer (non-melanoma), biliary cancer, extrahepatic bile duct cancer, intrahepatic bile duct cancer, bladder cancer, urinary bladder cancer, bone and joint cancer, osteosarcoma and malignant fibrous histiocytoma, brain cancer, brain tumor, brain stem glioma, cerebellar astrocytoma, cerebral astrocytoma/malignant glioma, ependymoma, medulloblastoma, supratentorial primitive neuroectodeimal tumors, visual pathway and hypothalamic glioma, breast cancer, including triple negative breast cancer, bronchial adenomas/carcinoids, carcinoid tumor, gastrointestinal, nervous system cancer, nervous system lymphoma, central nervous system cancer, central nervous system lymphoma, cervical cancer, childhood cancers, chronic lymphocytic leukemia, chronic myelogenous leukemia, chronic myeloproliferative disorders, colon cancer, colorectal cancer, cutaneous T-cell lymphoma, lymphoid neoplasm, mycosis fungoides, Seziary Syndrome, endometrial cancer, esophageal cancer, extracranial germ cell tumor, extragonadal germ cell tumor, extrahepatic bile duct cancer, eye cancer, intraocular melanoma, retinoblastoma, gallbladder cancer, gastric (stomach) cancer, gastrointestinal carcinoid tumor, gastrointestinal stromal tumor (GIST), germ cell tumor, ovarian germ cell tumor, gestational trophoblastic tumor glioma, head and neck cancer, hepatocellular (liver) cancer, Hodgkin lymphoma, hypopharyngeal cancer, intraocular melanoma, ocular cancer, islet cell tumors (endocrine pancreas), Kaposi Sarcoma, kidney cancer, renal cancer, laryngeal cancer, acute lymphoblastic leukemia, acute myeloid leukemia, chronic lymphocytic leukemia, chronic myelogenous leukemia, hairy cell leukemia, lip and oral cavity cancer, liver cancer, lung cancer, non-small cell lung cancer, small cell lung cancer, AIDS-related lymphoma, non-Hodgkin lymphoma, primary central nervous system lymphoma, Waldenstram macroglobulinemia, medulloblastoma, melanoma, intraocular (eye) melanoma, merkel cell carcinoma, mesothelioma malignant, mesothelioma, metastatic squamous neck cancer, mouth cancer, cancer of the tongue, multiple endocrine neoplasia syndrome, mycosis fungoides, myelodysplastic syndromes, myelodysplastic/myeloproliferative diseases, chronic my elogenous leukemia, acute myeloid leukemia, multiple myeloma, chronic myeloproliferative disorders, nasopharyngeal cancer, neuroblastoma, oral cancer, oral cavity cancer, oropharyngeal cancer, ovarian cancer, ovarian epithelial cancer, ovarian low malignant potential tumor, pancreatic cancer, islet cell pancreatic cancer, paranasal sinus and nasal cavity cancer, parathyroid cancer, penile cancer, pharyngeal cancer, pheochromocytoma, pineoblastoma and supratentorial primitive neuroectodermal tumors, pituitary tumor, plasma cell neoplasm/multiple myeloma, pleuropulmonary blastoma, prostate cancer, rectal cancer, renal pelvis and ureter, transitional cell cancer, retinoblastoma, rhabdomyosarcoma, salivary gland cancer, ewing family of sarcoma tumors, soft tissue sarcoma, uterine cancer, uterine sarcoma, skin cancer (non-melanoma), skin cancer (melanoma), papillomas, actinic keratosis and keratoacanthomas, merkel cell skin carcinoma, small intestine cancer, soft tissue sarcoma, squamous cell carcinoma, stomach (gastric) cancer, supratentorial primitive neuroectodermal tumors, testicular cancer, throat cancer, thymoma, thymoma and thymic carcinoma, thyroid cancer, transitional cell cancer of the renal pelvis and ureter and other urinary organs, gestational trophoblastic tumor, urethral cancer, endometrial uterine cancer, uterine sarcoma, uterine corpus cancer, vaginal cancer, vulvar cancer, and Wilm's Tumor. In some embodiments, the cancer is selected from the group consisting of melanoma, colorectal cancer, pancreatic cancer, bladder cancer, breast cancer, triple negative breast cancer, ovarian cancer and lung cancer.

The term “cylcloalkyl”, as used in this disclosure, refers to an alkyl that contains at least 3 carbon atoms but no more than 12 carbon atoms connected so that it forms a ring. A “cycloalkyl” for the purposes of this disclosure encompass from 1 to 7 cycloalkyl rings, wherein when the cycloalkyl is greater than 1 ring, then the cycloalkyl rings are joined so that they are linked, fused, or a combination thereof. A “cycloalkyl” can also include bicyclic and tricyclic-based groups. A cycloalkyl may be substituted or unsubstituted, or in the case of more than one cycloalkyl ring, one or more rings may be unsubstituted, one or more rings may be substituted, or a combination thereof.

The term “cylcloalkenyl”, as used in this disclosure, refers to an alkene that contains at least 3 carbon atoms but no more than 12 carbon atoms connected so that it forms a ring. A “cycloalkenyl” for the purposes of this disclosure encompass from 1 to 7 cycloalkenyl rings, wherein when the cycloalkenyl is greater than 1 ring, then the cycloalkenyl rings are joined so that they are linked, fused, or a combination thereof “Cycloalkenyl” can include bicyclic and tricyclic-based groups. A cycloalkenyl may be substituted or unsubstituted, or in the case of more than one cycloalkenyl ring, one or more rings may be unsubstituted, one or more rings may be substituted, or a combination thereof. Specific alkenyl groups include cycloprop-1-enyl, cyclobut-1-enyl, cyclobut-2-enyl, cyclopent-1-enyl, cyclohexenyl, all of which are optionally substituted.

The term “heterocycle”, as used in this disclosure, refers to ring structures that contain at least 1 noncarbon ring atom. A “heterocycle” for the purposes of this disclosure encompass from 1 to 7 heterocycle rings wherein when the heterocycle is greater than 1 ring the heterocycle rings are joined so that they are linked, fused, or a combination thereof. A heterocycle may be a hetero-aryl or nonaromatic, or in the case of more than one heterocycle ring, one or more rings may be nonaromatic, one or more rings may be hetero-aryls, or a combination thereof. A heterocycle may be substituted or unsubstituted, or in the case of more than one heterocycle ring one or more rings may be unsubstituted, one or more rings may be substituted, or a combination thereof. Typically, the noncarbon ring atom is N, O, S, Si, Al, B, or P. In case where there is more than one noncarbon ring atom, these noncarbon ring atoms can either be the same element, or combination of different elements, such as N and O. Examples of heterocycles include, but are not limited to: a monocyclic heterocycle such as, aziridine, oxirane, thiirane, azetidine, oxetane, thietane, pyrrolidine, pyrroline, imidazolidine, pyrazolidine, pyrazoline, dioxolane, sulfolane 2,3-dihydrofuran, 2,5-dihydrofuran tetrahydrofuran, thiophane, piperidine, 1,2,3,6-tetrahydro-pyridine, piperazine, morpholine, thiomorpholine, pyran, thiopyran, 2,3-dihydropyran, tetrahydropyran, 1,4-dihydropyridine, 1,4-dioxane, 1,3-dioxane, dioxane, homopiperidine, 2,3,4,7-tetrahydro-1H-azepine homopiperazine, 1,3-dioxepane, 4,7-dihydro-1,3-dioxepin, and hexamethylene oxide; and polycyclic heterocycles such as, indole, indoline, isoindoline, quinoline, tetrahydroquinoline, isoquinoline, tetrahydroisoquinoline, 1,4-benzodioxan, coumarin, dihydrocoumarin, benzofuran, 2,3-dihydrobenzofuran, isobenzofuran, chromene, chroman, isochroman, xanthene, phenoxathiin, thianthrene, indolizine, isoindole, indazole, purine, phthalazine, naphthyridine, quinoxaline, quinazoline, cinnoline, pteridine, phenanthridine, perimidine, phenanthroline, phenazine, phenothiazine, phenoxazine, 1,2-benzisoxazole, benzothiophene, benzoxazole, benzthiazole, benzimidazole, benztriazole, thioxanthine, carbazole, carboline, acridine, pyrolizidine, and quinolizidine. In addition to the polycyclic heterocycles described above, heterocycle includes polycyclic heterocycles wherein the ring fusion between two or more rings includes more than one bond common to both rings and more than two atoms common to both rings. Examples of such bridged heterocycles include quinuclidine, diazabicyclo[2.2.1]heptane and 7-oxabicyclo[2.2.1]heptane.

The terms “heterocyclic group”, “heterocyclic moiety”, “heterocyclic”, or “heterocyclo” used alone or as a suffix or prefix, refers to a heterocycle that has had one or more hydrogens removed therefrom.

The term “heterocyclyl” used alone or as a suffix or prefix, refers a monovalent radical derived from a heterocycle by removing a hydrogen therefrom. Heterocyclyl includes, for example, monocyclic heterocyclyls, such as, aziridinyl, oxiranyl, thiiranyl, azetidinyl, oxetanyl, thietanyl, pyrrolidinyl, pyrrolinyl, imidazolidinyl, pyrazolidinyl, pyrazolinyl, dioxolanyl, sulfolanyl, 2,3-dihydrofuranyl, 2,5-dihydrofuranyl, tetrahydrofuranyl, thiophanyl, piperidinyl, 1,2,3,6-tetrahydro-pyridinyl, piperazinyl, morpholinyl, thiomorpholinyl, pyranyl, thiopyranyl, 2,3-dihydropyranyl, tetrahydropyranyl, 1,4-dihydropyridinyl, 1,4-dioxanyl, 1,3-dioxanyl, dioxanyl, homopiperidinyl, 2,3,4,7-tetrahydro-1H-azepinyl, homopiperazinyl, 1,3-dioxepanyl, 4,7-dihydro-1,3-dioxepinyl, and hexamethylene oxidyl. In addition, heterocyclyl includes aromatic heterocyclyls or heteroaryl, for example, pyridinyl, pyrazinyl, pyrimidinyl, pyridazinyl, thienyl, furyl, furazanyl, pyrrolyl, imidazolyl, thiazolyl, oxazolyl, pyrazolyl, isothiazolyl, isoxazolyl, 1,2,3-triazolyl, tetrazolyl, 1,2,3-thiadiazolyl, 1,2,3-oxadiazolyl, 1,2,4-triazolyl, 1,2,4-thiadiazolyl, 1,2,4-oxadiazolyl, 1,3,4-triazolyl, 1,3,4-thiadiazolyl, and 1,3,4 oxadiazolyl. Additionally, heterocyclyl encompasses polycyclic heterocyclyls (including both aromatic or non-aromatic), for example, indolyl, indolinyl, isoindolinyl, quinolinyl, tetrahydroquinolinyl, isoquinolinyl, tetrahydroisoquinolinyl, 1,4-benzodioxanyl, coumarinyl, dihydrocoumarinyl, benzofuranyl, 2,3-dihydrobenzofuranyl, isobenzofuranyl, chromenyl, chromanyl, isochromanyl, xanthenyl, phenoxathiinyl, thianthrenyl, indolizinyl, isoindolyl, indazolyl, purinyl, phthalazinyl, naphthyridinyl, quinoxalinyl, quinazolinyl, cinnolinyl, pteridinyl, phenanthridinyl, perimidinyl, phenanthrolinyl, phenazinyl, phenothiazinyl, phenoxazinyl, 1,2-benzisoxazolyl, benzothiophenyl, benzoxazolyl, benzthiazolyl, benzimidazolyl, benztriazolyl, thioxanthinyl, carbazolyl, carbolinyl, acridinyl, pyrolizidinyl, and quinolizidinyl. In addition to the polycyclic heterocyclyls described above, heterocyclyl includes polycyclic heterocyclyls wherein the ring fusion between two or more rings includes more than one bond common to both rings and more than two atoms common to both rings. Examples of such bridged heterocycles include, but are not limited to, quinuclidinyl, diazabicyclo[2.2.1]heptyl; and 7-oxabicyclo[2.2.1]heptyl.

The term “hetero-aryl” used alone or as a suffix or prefix, refers to a heterocycle or heterocyclyl having aromatic character. Examples of heteroaryls include, but are not limited to, pyridine, pyrazine, pyrimidine, pyridazine, thiophene, furan, furazan, pyrrole, imidazole, thiazole, oxazole, pyrazole, isothiazole, isoxazole, 1,2,3-triazole, tetrazole, 1,2,3-thiadiazole, 1,2,3-oxadiazole, 1,2,4-triazole, 1,2,4-thiadiazole, 1,2,4-oxadiazole, 1,3,4-triazole, 1,3,4-thiadiazole, and 1,3,4-oxadiazole.

The term “hetero-” when used as a prefix, such as, hetero-alkyl, hetero-alkenyl, hetero-alkynyl, or hetero-hydrocarbon, for the purpose of this disclosure refers to the specified hydrocarbon having one or more carbon atoms replaced by non-carbon atoms as part of the parent chain. Examples of such non-carbon atoms include, but are not limited to, N, O, S, Si, Al, B, and P. If there is more than one non-carbon atom in the hetero-based parent chain then this atom may be the same element or may be a combination of different elements, such as N and 0.

The term “mixed ring system” refers to optionally substituted ring structures that contain at least two rings, and wherein the rings are joined together by linking, fusing, or a combination thereof. A mixed ring system comprises a combination of different ring types, including cycloalkyl, cycloalkenyl, aryl, and heterocycle.

As used herein, the term “Probiotic Composition” includes a composition comprising a probiotic commensal skin bacteria of the disclosure and may optionally include compounds described as Formula I or II, that affects the microbiome balance of the human skin and which can inhibit cancer growth, invation and/or metastasis and which can affect pathogen spread and proliferation. A probiotic composition can comprise an unnatural ratio or composition of an agent or microbe found in nature. For example, a microbial probiotic composition can comprise a single type of organism found on the skin (e.g., S. epidermidis MO34 or MO38 or MO34 and MO38) at a cell density or amount not normally found in nature. Alternatively, or in addition, the microbial probiotic composition can include a single type of organism as mentioned above, but which is present in a composition that does not occur in nature such as a salve, lotion, suspension, ointment and the like. In still another embodiment, a microbial probiotic composition can comprise a microbe at a density not normally found in nature or mixed with a non-naturally occurring composition at a density not found in nature. In still another embodiment, a microbial probiotic composition can comprise a recombinantly engineered microorganism (e.g., an attenuated bacterial species). In one embodiment, commensal skin bacteria is a bacteria that produces 6-HAP. In another or further embodiment, the bacteria comprises S. epidermidis MO34 and/or MO38.

The term “purified” and “substantially purified” as used herein refers to cultures, or co-cultures of microorganisms or of biological agent (e.g. fermentation media and extracts, fractionated fermentation media, fermentation by-products, compounds of Formula I or II etc.) that is substantially free of other cells or components found in the natural environment with which an in vivo-produced agent would naturally be associated. In some embodiments, a co-culture probiotic can comprise one or a plurality of commensal skin bacteria.

The term “substituted” with respect to hydrocarbons, heterocycles, and the like, refers to structures wherein the parent chain contains one or more substituents. For example, optionally substituted hydrocarbons, hetero-hydrocarbons, heterocycles, mixed ring systems, and the like, can include substitution with one or more of the following substituents: halogens, CN, —COOR, —OR, —COR, —OCOOR, —CON(R)₂, —OCON(R)₂, —N(R)₂, NO₂, —SR, —SO₂R, —SO₂N(R)₂ or —SOR groups, wherein R is selected from the group comprising a hydrocarbon, a hetero-hydrocarbon, heterocycle, and mixed ring system. Optional substitution of alkyl groups includes substitution with one or more alkenyl groups, aryl groups or both, wherein the alkenyl groups or aryl groups are also optionally substituted. Optional substitution of alkenyl groups includes substitution with one or more alkyl groups, aryl groups, or both, wherein the alkyl groups or aryl groups are also optionally substituted. Optional substitution of aryl groups includes substitution of the aryl ring with one or more alkyl groups, alkenyl groups, or both, wherein the alkyl groups or alkenyl groups are also optionally substituted.

The term “substituent” refers to an atom or group of atoms substituted in place of a hydrogen atom. For purposes of this disclosure, a substituent would include deuterium atoms.

Optional substituents for hydrocarbons, hetero-hydrocarbons, heterocycles, mixed ring systems, and the like, include among others:

—COOR where R is a hydrogen or an alkyl group or an aryl group and more specifically where R is methyl, ethyl, propyl, butyl, or phenyl groups all of which are optionally substituted;

—COR where R is a hydrogen, or an alkyl group or an aryl groups and more specifically where R is methyl, ethyl, propyl, butyl, or phenyl groups all of which groups are optionally substituted;

—CON(R)₂ where each R, independently of each other R, is a hydrogen or an alkyl group or an aryl group and more specifically where R is methyl, ethyl, propyl, butyl, or phenyl groups all of which groups are optionally substituted; R and R can form a ring which may contain one or more double bonds;

—OCON(R)₂ where each R, independently of each other R, is a hydrogen or an alkyl group or an aryl group and more specifically where R is methyl, ethyl, propyl, butyl, or phenyl groups all of which groups are optionally substituted; R and R can form a ring which may contain one or more double bonds;

—N(R)₂ where each R, independently of each other R, is a hydrogen, or an alkyl group, acyl group or an aryl group and more specifically where R is methyl, ethyl, propyl, butyl, or phenyl or acetyl groups all of which are optionally substituted; or R and R can form a ring which may contain one or more double bonds;

—SR, —SO₂R, or —SOR where R is an alkyl group or an aryl groups and more specifically where R is methyl, ethyl, propyl, butyl, phenyl groups all of which are optionally substituted; for example —SR, R can be hydrogen;

—OCOOR where R is an alkyl group or an aryl groups;

—SO₂N(R)₂ where R is a hydrogen, an alkyl group, or an aryl group and R and R can form a ring; and

—OR where R═H, alkyl, aryl, or acyl; for example, R can be an acyl yielding —OCOR* where R* is a hydrogen or an alkyl group or an aryl group and more specifically where R* is methyl, ethyl, propyl, butyl, or phenyl groups all of which groups are optionally substituted.

As used herein, the term “Topical” can include administration to the skin externally, as well as shallow injection (e.g., intradermally and intralesionally as described in the Examples) such that a topical probiotic composition described herein comes in direct contact with skin.

The term “unsubstituted” with respect to hydrocarbons, heterocycles, and the like, refers to structures wherein the parent chain contains no substituents.

As used herein, a wavy line intersecting another line that is connected to an atom indicates that this atom is covalently bonded to another entity that is present but not being depicted in the structure. A wavy line that does not intersect a line but is connected to an atom indicates that this atom is interacting with another atom by a bond or some other type of identifiable association.

A bond indicated by a straight line and a dashed line indicates that the bond may be a single covalent bond or alternatively a double covalent bond. But in the case where a ring atom's maximum valence would be exceeded by forming a double covalent bond with another ring atom, then the bond would be a single covalent bond.

For the purposes of this disclosure, in the instance that a ring atom designated as X would exceed its maximum valence by binding a group designated by R, then the group designated by R would be absent.

Mammalian skin harbors diverse microbial communities whose growth is influenced by ecological factors on the body surface such as humidity, temperature, pH, lipid content, and the presence of antimicrobials produced by the host. Although the specific mechanisms through which skin surface microbes influence host function are incompletely understood, specific strains of coagulase-negative staphylococcal species have been shown to produce proteins that work together with endogenous host antimicrobial peptides (AMPs) to provide direct protection against infectious pathogens. For example, the production of phenol-soluble modulins (PSMg and PSMd) by S. epidermidis can selectively kill bacterial pathogens such as S. aureus and group A Streptococcus (GAS). This species has also been shown to benefit skin immune function by diminishing inflammation after injury, enhancing development of cutaneous T cells and promoting expression of host AMPs such as cathelicidins and b-defensins. Germ-free mice are more susceptible to skin infection than mice maintained under specific pathogen-free conditions or mono associated with S. epidermidis.

Further evidence that commensal Staphylococcus species provide host defense has come from observations that nasal colonization with either a specific strain of S. epidermidis that produces a serine protease or a strain of Staphylococcus lugdunensis that produces a thiazolidine containing cyclic peptide can inhibit nasal colonization by S. aureus. More recently, several strains of S. epidermidis, S. hominis, and other coagulase-negative staphylococcal species that produce a variety of previously unknown AMPs were found to be deficient in atopic dermatitis patients colonized by S. aureus, and a clinical trial evaluating the effect of reintroduction of these strains demonstrated that they directly reduced S. aureus colonization on humans. Thus, evidence is increasing that the skin microbiome has an important role in promoting host defense.

These observations suggest that the skin microbiome may contribute to aspects of host defense. The disclosure describes the molecular analysis of the metabolic products of human skin commensal bacteria. Unexpectedly it was found that S. epidermidis strain MO34 and MO38 produce a nucleobase analog with the capacity to inhibit DNA synthesis. When administered intravenously or topically applied to mice, this molecule or the live S. epidermidis strain(s) itself suppressed tumor growth in vivo.

The disclosure provides a composition for treating cancer and/or a pathogen infection comprising a compound of formula I(a), I(b) and/or II, alone or in combination with (e.g., produced by) a commensal probiotic composition comprising an S. epidermidis strain that produces a compound of the disclosure. In one embodiment, the disclosure provides a method and composition comprising 6-HAP. In one embodiment, the composition and method comprise a probiotic commensal bacterial the produces 6-HAP. In another embodiment, the composition and method comprise a substantially purified 6-HAP or analog or derivative thereof. In another or further embodiment, the composition comprising 6-HAP comprises a commensal probiotic and a purified 6-HAP or analog or derivative thereof.

The disclosure demonstrates that compounds comprising a structure of Formula I(a), Formula I(b) and/or Formula II have the ability to inhibit replication and expression of DNA. For example, the disclosure demonstrates that a compound for Formula II (6-HAP) has important and unique host defense capabilities. 6-HAP suppressed growth of major skin pathogens such as GAS, GBS, S. aureus (including MRSA) and P. aeruginosa. Importantly, this antimicrobial activity was selective for these skin pathogens over human skin commensals such as S. epidermidis, S. hominis and P. acnes. Thus, the disclosure provides methods and compositions useful for treating infections by contacting a pathogen with a compound of Formula I(a), I(b) and/or II alone or in combination with a probiotic commensal bacterial fo the disclosure.

In addition, an unexpected discovery was made while studying the mechanism of action of 6-HAP that led to the identification that this molecule also has selective anti-proliferative function against mammalian tumor cell lines and UV-induced skin tumor. As described elsewhere herein, the 6-HAP compound or derivatives thereof (e.g., Formula I(a), and I(b)) as well as probiotic commensal bacterial of the disclosure that can produce 6-HAP can be used to treat neoplasm and cancer.

The disclosure demonstrates that 6-HAP did not exert activity through disruption of cell membranes. 6-HAP directly inhibited adenine-thymidine base pair matching in a cell free assay. Thus, the mechanism of action of 6-HAP is through inhibition of DNA synthesis. In 6-HAP, the amino group at the carbon C-6 position of the purine ring is replaced with a hydroxyamino group. This is a critical position for DNA synthesis since the hydrogen of the amino group at the carbon C-6 position of adenine is required to bind with oxygen at the carbon C-4 position of thymine.

Commensal skin microbes have not previously been shown to produce nucleobase analogs with such activity. However, the capacity of other chemically-synthesized nucleobase analogs to inhibit DNA synthesis is known. For example, 6-mercaptopurine is converted in vivo to 6-thioguanine and is then incorporated into DNA in place of guanine. 8-Azaguanine also suppresses DNA synthesis by a similar mechanism. Similarly to 6-HAP, 6-thioguanine and 8-azaguanine have both antibiotic and antineoplastic activities. It is highly unlikely that a common commensal produces a potent mutagen that would not be previously detected. However, if this was indeed the case, the current observations would remain highly significant since this would identify a previously undetected risk factor for cancer. Thus, this observation of the capacity of a commensal skin microbe to produce a nucleobase analog is highly significant.

A remarkable quality of 6-HAP as a nucleobase analog is the capacity to exert selective activity against pathogenic bacteria and tumor cell lines, but little toxicity to commensals or normal cells. Previously identified AMPs from S. epidermidis or S. hominis were also known to exert selective killing, a logical behavior if the host cell is to resist killing itself. The mechanism responsible for selective killing by these AMPs is poorly understood but thought to be due to differences in the capacity to disrupt the cell membrane. In the case of 6-HAP, only some pathogens and cancer cell lines were inhibited in vitro and in vivo. No systemic toxicity of 6-HAP was observed when mice were repeatedly administrated this intravenously, nor were growth of normal keratinocytes inhibited by high concentrations of 6-HAP in culture. In contrast, the DNA synthesis inhibitor mitomycin C did not show such selective effects on cell growth. The evidence therefore suggest that the selectivity by 6-HAP is not simply due to the rate of cell division. 6-HAP exhibits no toxicity to a wild-type strain of E. coli, whereas it inhibited growth of mutant strains deficient in genes involved in molybdenum cofactors. The data herein demonstrate that the molybdoenzyme mARC2 protected NHEKs from 6-HAP. In addition, relative expression level of mARC2 was higher in NHEKs than cancer cell lines. Moreover, the disclosure demonstrates the involvement of molybdoenzymes that may be capable of detoxifying 6-HAP to enable selective activity. Thus, in one embodiment, the disclosure provides a method of treating an infection or cancer, wherein the pathogen of the infection or the cancer cell has mARC2 expression at a level that is less than normal healthy cells of the subject, the method comprising administering a probiotic of the disclosure and/or a compound of formula I(a), I(b) and/or II to the pathogen or cancer cell.

The disclosure thus provides an entirely new concept that some members of our skin microbiome may suppress tumor growth and UV-induced tumor formation. Most prior observations have reported that dysbiosis (a state of altered microbiome) can promote cancer. Observations associating bacteria in the gut with an increase in carcinogenesis suggested this effect was dependent on inflammation. Intestinal inflammation has also been reported to promote development of tumors through increasing the capacity of microbiota to produce genotoxins which elicit DNA damage.

The importance of this disclosure are several fold. The selective activity of 6-HAP may be essential for maintaining homeostasis of the skin microbiome and could be exploited therapeutically to treat S. aureus infection or colonization, which plays important role in pathogenesis of atopic dermatitis, as well as in treating cancer progression or skin damage leading to cancer. Such a strategy for defense is theoretically superior to the use of existing pharmaceutical antibiotics or antiseptics that non-specifically kill beneficial commensal bacteria and disrupt homeostasis by killing the normal microflora. In addition, long-lasting protection could be achieved if the applied beneficial bacteria could successfully colonize on the skin surface. Further, the disclosure shows the surprising presence of anti-neoplastic activity from S. epidermidis. The observation that a bacterial product can directly limit tumor growth suggests a paradigm shift in the understanding of the functions of the human skin microbiome.

The disclosure thus provides a method of treating or reducing the risk of skin infection and/or cancer (e.g., skin cancer) by promoting an effective skin biome comprising S. epidermidis that produces 6-HAP. The disclosure also provides a method of treating or reducing the risk of infection and/or skin cancer comprising administering a probiotic comprising S. epidermidis that produces an anticancer agent of the disclosure. In one embodiment, the probiotic composition comprises S. epidermidis MO34 and/or MO38 or attenuated or genetically engineered strains thereof.

The disclosure provides a probiotic composition for inhibiting and/or modulating skin damage and neoplasms, more particularly of the skin, and preferably human skin. In particular embodiment, the probiotic composition of the disclosure comprises a commensal strain of Staphylococcus epidermidis that protects against skin neoplasia by producing the compound 6-N-hydroxyaminopurine (6-HAP). In one embodiment, the straing is S. epidermidis MO34 and/or MO38.

The probiotic compositions of the disclosure can be used to treat neoplastic diseases and disorders, improve healing and reduce morbidity associated with skin damage and neoplasms as well as treating infection through the antimicrobial activity of 6-HAP. For example, a topical probiotic compositions can be used to treat a skin damage caused by UV irradiation by contacting the skin with a therapeutically effective amount or inhibitive effective amount of a composition as described below and herein. The composition can comprise one or more of an S. epidermidis MO34 and/or MO35 alone or in combination with 6-HAP or the 6-HAP or a derivative thereof alone and any other desired active ingredients that improves skin health.

Any of a variety of methods known in the art can be used to administer a probiotic composition or compound of the disclosure to a subject. For example, a 6-HAP anti-neoplastic agent and/or microbial probiotic composition of the disclosure may be formulated for topical administration (e.g., as a lotion, cream, spray, gel, or ointment). Such topical formulations are useful in treating or inhibiting neoplastic cells, UV damage leading to neoplasms and the like. Examples of formulations include topical lotions, creams, soaps, wipes, and the like. In embodiments, where a neoplasia or cancer is not topical, the administration of a compound of formula I(a), I(b) and/or II can be delivered intraperitoneally, intravenously, by inhalation etc.

The disclosure thus provides a method of treating or reducing the risk of cancer (e.g., skin cancer) by promoting an effective skin biome comprising S. epidermidis. The disclosure also provides a method of treating or reducing the risk of skin cancer comprising administering a probiotic comprising S. epidermidis that produces an anticancer agent of the disclosure.

The disclosure also provides an antimicrobial/anticancer molecule having the general formula of Formula I(a):

or a pharmaceutically acceptable salt or prodrug thereof, wherein,

N¹-N⁵ are nitrogen atoms;

X¹-X² are carbon atoms;

the R groups attached by a dashed line are present, or are not present if the R group is connected to an atom that is bound to another atom by a double covalent bond;

the bond indicated by both a straight line and a dashed line indicate that the bond may be a single covalent bond or a double covalent bond;

the fused heterocyclic ring system comprises three double bonds with N² or N³ forming a double bond and with X¹, and with N⁴ or N⁵ forming a double bond with X²;

R¹ is a hydroxyl, ester, carboxylic acid, or —O—R¹⁰;

R², R⁴, R⁵, R⁷-R⁹ are independently a H, D, optionally substituted (C₁-C₆)-alkyl, optionally substituted (C₁-C₆)-alkenyl, optionally substituted (C₁-C₆)-alkynyl, optionally substituted (C₃-C₁₂)cycloalkyl, optionally substituted (C₄-C₁₂)cycloalkenyl, optionally substituted aryl;

R³ and R⁶ are independently selected from a H, D, optionally substituted (C₁-C₆)-alkyl, optionally substituted (C₁-C₆)-heteroalkyl, optionally substituted (C₁-C₆)-alkenyl, optionally substituted (C₁-C₆)-heteroalkenyl, optionally substituted (C₁-C₆)-alkynyl, optionally substituted (C₁-C₆)-heteroalkynyl, optionally substituted (C₃-C₁₂)cycloalkyl, optionally substituted (C₄-C₁₂)cycloalkenyl, optionally substituted aryl, optionally substituted heterocycle, halide, hydroxyl, carbonyl, aldehyde, carboxyl, ester, alkoxy, carboxyamide, amine, imine, azide, cyano, nitro, nitroso, thiol, sulfide, sulfoxide, sulfone, and phosphate;

R¹⁰ is selected from D, optionally substituted (C₁-C₆)-alkyl, optionally substituted (C₁-C₆)-heteroalkyl, optionally substituted (C₁-C₆)-alkenyl, optionally substituted (C₁-C₆)-heteroalkenyl, optionally substituted (C₁-C₆)-alkynyl, optionally substituted (C₁-C₆)-heteroalkynyl, optionally substituted (C₃-C₁₂)cycloalkyl, optionally substituted (C₄-C₁₂)cycloalkenyl, optionally substituted aryl, and optionally substituted heterocycle. In another embodiment, the compound has the general formulat of Formulat I(b):

or a pharmaceutically acceptable salt or prodrug thereof, wherein,

N¹-N⁵ are nitrogen atoms;

X¹-X² are carbon atoms;

the R groups attached by a dashed line are present, or are not present if the R group is connected to an atom that is bound to another atom by a double covalent bond;

the bond indicated by both a straight line and a dashed line indicate that the bond may be a single covalent bond or a double covalent bond;

the fused heterocyclic ring system comprises three double bonds with N² or N³ forming a double bond with X¹, and with N⁴ or N⁵ forming a double bond with X²;

R¹ is a hydroxyl, ester, carboxylic acid, or —O—R¹⁰;

R², R⁴, R⁵, and R⁷ are independently a H, D, optionally substituted (C₁-C₆)-alkyl, optionally substituted (C₁-C₆)-alkenyl, optionally substituted (C₁-C₆)-alkynyl, optionally substituted (C₃-C₁₂)cycloalkyl, optionally substituted (C₄-C₁₂)cycloalkenyl, optionally substituted aryl;

R¹⁰ is selected from D, optionally substituted (C₁-C₆)-alkyl, optionally substituted (C₁-C₆)-heteroalkyl, optionally substituted (C₁-C₆)-alkenyl, optionally substituted (C₁-C₆)-heteroalkenyl, optionally substituted (C₁-C₆)-alkynyl, optionally substituted (C₁-C₆)-heteroalkynyl, optionally substituted (C₃-C₁₂)cycloalkyl, optionally substituted (C₄-C₁₂)cycloalkenyl, optionally substituted aryl, and optionally substituted heterocycle.

In yet another embodiment, the disclosure provides a compound of general formula II:

or a pharmaceutically acceptable salt or prodrug thereof; or a tautomer of the compound of Formula II, or a pharmaceutically acceptable salt or prodrug of the tautomer of compound of Formula II thereof.

Methods and compositions useful for treatment of cancer are provided. In one embodiment the disclosure provides compositions and methods useful for treating a cancer wherein the methods and compositions comprise Formula I(a), I(b) and/or II, a derivative or salt thereof. The methods and compositions of the disclosure can be used alone or in combination with other anticancer agents to treat such cancer. In one embodiment, the composition comprises S. epidermidis MO34 and/or MO38 in addition to a compound of Formula I(a), I(b) and/or II.

Suitable acids for use in the preparation of pharmaceutically acceptable salts of a compound of the disclosure, include, but are not limited to, aceptic acid, 2,2-dichoroacetic acid, acylated amino acids, adipic acid, alginic acid, ascorbic acid, L-aspartic acid, benzenesulfonic acid, benzoic acid, 4-acetamidobenzoic acid, boric acid, (+)-camphoric acid, camphorsulfonic acid, (+)-(1S)-camphor-10-sulfonic acid, capric acid, caproic acid, caprylic acid, cinnamic acid, citric acid, cyclamic acid, cyclohexanesulfamic acid, dodecylsulfuric acid, ethane-1,2-disulfonic acid, ethanesulfonic acid, 2-hydroxy-ethanesulfonic acid, formic acid, fumaric acid, galactaric acid, gentisic acid, glucoheptonic acid, D-gluconic acid, D-glucuronic acid, L-glutamic acid, α-oxo-glutaric acid, glycolic acid, hippuric acid, hydrobromic acid, hydrochloric acid, hydroiodic acid, (+)-L-lactic acid, (+/−)-DL-lactic acid, lactobionic acid, lauric acid, maleic acid, (−)-L-malic acid, malonic acid, (+/−)-DL-mandelic acid, methanesulfonic acid, naphthalene-2-sulfonic acid, naphthalene-1,5-disulfonic acid, 1-hydroxy-2-naphtoic acid, nicotinic acid, nitric acid, oleic acid, orotic acid, oxalic acid, palmitic acid, pamoic acid, perchloric acid, phosphoric acid, L-pyroglutamic acid, saccharic acid, salicyclic acid, 4-amino-salicylic acid, sebacic acid, stearic acid, succinic acid, sulfuric acid, tannic acid, (+)-L-tartaric acid, thiocyanic acid, p-toluenesulfonic acid, undecylenic acid, and valeric acid.

Suitable acids for use in the preparation of pharmaceutically acceptable salts, include, but are not limited to, inorganic bases, such as magnesium hydroxide, calcium hydroxide, potassium hydroxide, zinc hydroxide, or sodium hydroxide; and organic bases, such as primary, secondary, tertiary, and quaternary, aliphatic and aromatic amines, including L-arginine, benethamine, benzathine, choline, deanol, diethanolamine, diethylamine, dimethylamine, dipropylamine, diisopropylamine, 2-(diethylamino)-ethanol, ethanolamine, ethylamine, ethylenediamine, isopropylamine, N-methyl-glucamine, hydrabamine, 1H-imidazole, L-Lysine, morpholine, 4-(2-hydroxyethyl)-morpholine, methylamine, piperidine, piperazine, propylamine, pyrrolidine, 1-(2-hydroxyethyl)-pyrrolidine, pyridine, quinuclidine, quinoline, isoquinoline, secondary amines, triethanolamine, trimethylamine, triethylamine, N-methyl-D-glucamine, 2-amino-2-(hydroxymethyl)-1,3-propanediol, and tromethamine.

Pharmaceutically acceptable salts comprise pharmaceutically-acceptable anions and/or cations. Pharmaceutically-acceptable cations include among others, alkali metal cations (e.g., Li+, Na+, K+), alkaline earth metal cations (e.g., Ca²⁺, Mg²⁺), non-toxic heavy metal cations and ammonium (NH₄ ⁺) and substituted ammonium (N(R′)₄ ⁺, where R′ is hydrogen, alkyl, or substituted alkyl, i.e., including, methyl, ethyl, or hydroxyethyl, specifically, trimethyl ammonium, triethyl ammonium, and triethanol ammonium cations). Pharmaceutically-acceptable anions include among other halides (e.g., Cl—, Br—), sulfate, acetates (e.g., acetate, trifluoroacetate), ascorbates, aspartates, benzoates, citrates, and lactate.

A compound disclosed herein may also have a prodrug form. A prodrug is a functional derivative of the compound disclosed herein and is readily convertible into the parent compound in vivo. Prodrugs are often useful because, in some situations, they may be easier to administer than the parent compound. They may, for instance, be bio-available by oral administration whereas the parent compound is not. The prodrug may also have enhanced solubility in pharmaceutical compositions over the parent compound. A prodrug may be converted into the parent drug by various mechanisms, including enzymatic processes and metabolic hydrolysis. Various examples and forms of prodrugs are well known in the art. Examples of prodrugs are found, inter alia, in Design of Prodrugs, edited by H. Bundgaard, (Elsevier, 1985), Methods in Enzymology, Vol. 42, at pp. 309-396, edited by K. Widder, et. al. (Academic Press, 1985); A Textbook of Drug Design and Development, edited by Krosgaard-Larsen and H. Bundgaard, Chapter 5, “Design and Application of Prodrugs,” by H. Bundgaard, at pp. 113-191, 1991); H. Bundgaard, Advanced Drug Delivery Reviews, Vol. 8, p. 1-38 (1992); H. Bundgaard, et al., Journal of Pharmaceutical Sciences, Vol. 77, p. 285 (1988); and Nogrady (1985) Medicinal Chemistry A Biochemical Approach, Oxford University Press, New York, pages 388-392). In a specific example, if a parent compound disclosed herein has a hydroxyl group, this hydroxyl group may be converted to an ester in attempts to increase bioavailability, solubility, injection site pain relief, elimination of an unpleasant taste, decreased toxicity, decreased metabolic inactivation, increased chemical stability, and/or prolonged or shortened action of the hydroxyl containing parent compound. In another specific example, if a parent compound disclosed herein has an amine group, this amine group may be converted to a Schiff base in attempts to increase bioavailability, solubility, injection site pain relief, elimination of an unpleasant taste, decreased toxicity, decreased metabolic inactivation, increased chemical stability, and/or prolonged or shortened action of the hydroxyl containing parent compound.

A pharmaceutical composition comprising a compound disclosed herein, a derivative or analog thereof, including pharmaceutical salt forms and prodrug forms, can be in a form suitable for administration to a subject using carriers, excipients, and additives or auxiliaries. Frequently used carriers or auxiliaries include magnesium carbonate, titanium dioxide, lactose, mannitol and other sugars, talc, milk protein, gelatin, starch, vitamins, cellulose and its derivatives, animal and vegetable oils, polyethylene glycols and solvents, such as sterile water, alcohols, glycerol, and polyhydric alcohols. Intravenous vehicles include fluid and nutrient replenishers. Preservatives include antimicrobial, chelating agents, and inert gases. Other pharmaceutically acceptable carriers include aqueous solutions, non-toxic excipients, including salts, preservatives, buffers and the like, as described, for instance, in Remington's Pharmaceutical Sciences, 15th ed., Easton: Mack Publishing Co., 1405-1412, 1461-1487 (1975), and The National Formulary XIV., 14th ed., Washington: American Pharmaceutical Association (1975), the contents of which are hereby incorporated by reference. The pH and exact concentration of the various components of the pharmaceutical composition are adjusted according to routine skills in the art. See Goodman and Gilman's, The Pharmacological Basis for Therapeutics (7th ed.).

A pharmaceutical composition comprising a probiotic disclosed herein comprising a commensal bacterial (e.g., S. epidermidis MO34 and/or MO38) or an engineered form thereof (e.g., attenuated or genetically modified), may be formulated in any dosage form that is suitable for topical administration for local or systemic effect, including emulsions, solutions, suspensions, creams, gels, hydrogels, ointments, dusting powders, dressings, elixirs, lotions, suspensions, tinctures, pastes, foams, films, aerosols, irrigations, sprays, suppositories, bandages, dermal patches. The topical formulation comprising a probiotic disclosed herein may also comprise liposomes, micelles, microspheres, nanosystems, and mixtures thereof.

In one embodiment, a bandage or dressing is provided comprising a compound of formula I(a), I(b) and/or II, and/or a probiotic commensal skin bacteria described herein. In various aspects, a bandage or dressing is provided the major constituents of which includes a matrix and a topical probiotic composition of Formulas I or II described above. In various aspects, a bandage or dressing is provided the major constituents of which includes a matrix and a probiotic commensal skin bacteria. In various aspects, a bandage or dressing is provided the major constituents of which includes a matrix and a probiotic commensal skin bacteria fermentation extract. In various aspects, a bandage or dressing is provided the major constituents of which includes a matrix and glycerol. In one embodiment, the bandage or dressing is applied to site of skin damage or injury. In another embodiment, the bandage or dressing is applied to a site of infection.

A “pharmaceutically acceptable carrier” is intended to include solvents, dispersion media, coatings, antibacterial and antifungal agents (as needed so long as they are not detrimental to the probiotic commensal bacteria), isotonic and absorption delaying agents, and the like. The use of such media and agents for pharmaceutically active substances is well known in the art. Except insofar as any conventional media or agent is incompatible with the pharmaceutical composition, use thereof in the therapeutic compositions and methods of treatment is contemplated. Supplementary active compounds can also be incorporated into the compositions.

Pharmaceutically acceptable carriers and excipients suitable for use in the topical formulations disclosed herein include, but are not limited to, aqueous vehicles, water-miscible vehicles, non-aqueous vehicles, stabilizers, solubility enhancers, isotonic agents, buffering agents, antioxidants, local anesthetics, suspending and dispersing agents, wetting or emulsifying agents, complexing agents, sequestering or chelating agents, penetration enhancers, cryopretectants, lyoprotectants, thickening agents, and inert gases.

A pharmaceutical composition comprising a probiotic may be formulated in the forms of ointments, creams, sprays and gels. Suitable ointment vehicles include oleaginous or hydrocarbon vehicles, including such as lard, benzoinated lard, olive oil, cottonseed oil, and other oils, white petrolatum; emulsifiable or absorption vehicles, such as hydrophilic petrolatum, hydroxystearin sulfate, and anhydrous lanolin; water-removable vehicles, such as hydrophilic ointment; water-soluble ointment vehicles, including polyethylene glycols of varying molecular weight; emulsion vehicles, either water-in-oil (W/O) emulsions or oil-in-water (O/W) emulsions, including cetyl alcohol, glyceryl monostearate, lanolin, and stearic acid (see, Remington: The Science and Practice of Pharmacy). These vehicles are emollient but generally require addition of antioxidants and preservatives.

Suitable cream base can be oil-in-water or water-in-oil. Cream vehicles may be water-washable, and contain an oil phase, an emulsifier, and an aqueous phase. The oil phase is also called the “internal” phase, which is generally comprised of petrolatum and a fatty alcohol such as cetyl or stearyl alcohol. The aqueous phase usually, although not necessarily, exceeds the oil phase in volume, and generally contains a humectant. The emulsifier in a cream formulation may be a nonionic, anionic, cationic, or amphoteric surfactant.

Gels are semisolid, suspension-type systems. Single-phase gels contain material substantially uniformly throughout the liquid carrier. Suitable gelling agents include crosslinked acrylic acid polymers, such as carbomers, carboxypolyalkylenes, Carbopol®; hydrophilic polymers, such as polyethylene oxides, polyoxyethylene-polyoxypropylene copolymers, and polyvinylalcohol; cellulosic polymers, such as hydroxypropyl cellulose, hydroxyethyl cellulose, hydroxypropyl methylcellulose, hydroxypropyl methylcellulose phthalate, and methylcellulose; gums, such as tragacanth and xanthan gum; sodium alginate; and gelatin. In order to prepare a uniform gel, dispersing agents such as alcohol or glycerin can be added, or the gelling agent can be dispersed by trituration, mechanical mixing, and/or stirring.

A pharmaceutical composition comprising a probiotic disclosed herein, may be administered rectally, urethrally, vaginally, or perivaginally in the forms of suppositories, pessaries, bougies, poultices or cataplasm, pastes, powders, dressings, creams, plasters, contraceptives, ointments, solutions, emulsions, suspensions, tampons, gels, foams, sprays, or enemas. These dosage forms can be manufactured using conventional processes as described in Remington: The Science and Practice of Pharmacy.

The pharmaceutical compositions according to the disclosure may be administered locally or systemically. A “therapeutically effective dose” is the quantity of an agent (e.g., a compound of Formula I(a), I(b) and/or II) or a probiotic comprising a commensal bacterial according to the disclosure necessary to prevent, to cure, or at least partially arrest the symptoms of cancer (e.g., proliferation, metastasis, growth etc.). Amounts effective for this use will, of course, depend on the severity of the cancer, the weight and general state of the subject and/or the surface area to be treated. Typically, dosages used in vitro may provide useful guidance in the amounts useful for human and animal treatment. Various considerations are described, e.g., in Langer, Science, 249: 1527, (1990); Gilman et al. (eds.) (1990), each of which is herein incorporated by reference. Dosage regima can be adjusted to provide the optimum therapeutic response. For example, several divided doses can be administered daily or the dose can be proportionally reduced as indicated by the exigencies of the therapeutic situation.

The principal pharmaceutical composition is compounded for convenient and effective administration in effective amounts with a suitable pharmaceutically acceptable carrier in an acceptable dosage unit. In the case of compositions containing supplementary active ingredients, the dosages are determined by reference to the usual dose and manner of administration of the said ingredients.

The disclosure provides for a compound (e.g., a compound of Formula I(a), I(b) and/or II) disclosed herein, derivative or analog thereof, including pharmaceutical salt forms and prodrug forms, that can be administered to any host, including a human or non-human animal, in an amount effective to inhibit the growth, spread or proliferation of a cancer cell or neoplasm. In one embodiment, the administration results in the inhibition of growth, proliferation, migration and/or metastasis of a cancer or neoplastic cell.

Any of a variety of art-known methods can be used to administer a compound (e.g., a compound of Formula I(a), I(b) and/or II) disclosed herein, a derivative or analog thereof, including pharmaceutical salt forms and prodrug forms, either alone or used in combination with one or more other therapeutic agents. For example, administration can be parenterally by injection or by gradual infusion over time. The agent(s) can be administered intravenously, intraperitoneally, intramuscularly, subcutaneously, intracavity, by inhalation, topically or transdermally.

A pharmaceutical composition (e.g., a compound of Formula I(a), I(b) and/or II or a probiotic composition comprising a commensal bacterial such as S. epidermidis MO34 and/or MO38, or a combination of a commensal bacteria and a compound of the disclosure) can be administered in a convenient and appropriate manner, such as by injection (subcutaneous, intravenous, etc.), oral administration, inhalation, transdermal application, topical via lotion, creame or ointment, or rectal administration. Depending on the route of administration, the pharmaceutical composition can be coated with a material to protect the pharmaceutical composition from the action of enzymes, acids, and other natural conditions that may inactivate the pharmaceutical composition. The pharmaceutical composition can also be administered parenterally or intraperitoneally. Dispersions can also be prepared in glycerol, liquid polyethylene glycols, and mixtures thereof, and in oils. Under ordinary conditions of storage and use, these preparations may contain a preservative to prevent the growth of microorganisms.

In another embodiment, a pharmaceutical composition comprising a compound and/or a commenal probiotic disclosed herein, a derivative or analog thereof, including pharmaceutical salt forms and prodrug forms, can be formulated either alone or in combination with one or more additional therapeutic agents, including, but not limited to, chemotherapeutics, antibiotics (so long as they don't destroy the probiotic benefits), antifungal-agents, anti-pruritics, analgesics, and/or antiviral agents.

Topical administration, as used herein, include (intra)dermal, conjunctival, intracorneal, intraocular, ophthalmic, auricular, transdermal, nasal, vaginal, uretheral, respiratory, and rectal administration. Such topical formulations are useful in treating or inhibiting cancers of the eye, skin, and mucous membranes (e.g., mouth, vagina, rectum). Examples of formulations in the market place include topical lotions, creams, soaps, wipes, and the like.

Rectal, urethral, and vaginal suppositories are solid bodies for insertion into body orifices, which are solid at ordinary temperatures but melt or soften at body temperature to release the active ingredient(s) inside the orifices. Pharmaceutically acceptable carriers utilized in rectal and vaginal suppositories include bases or vehicles, such as stiffening agents, which produce a melting point in the proximity of body temperature, when formulated with the pharmaceutical compositions disclosed herein; and antioxidants as described herein, including bisulfite and sodium metabisulfite. Suitable vehicles include, but are not limited to, cocoa butter (theobroma oil), glycerin-gelatin, carbowax (polyoxyethylene glycol), spermaceti, paraffin, white and yellow wax, and appropriate mixtures of mono-, di- and triglycerides of fatty acids, hydrogels, such as polyvinyl alcohol, hydroxyethyl methacrylate, polyacrylic acid; glycerinated gelatin. Combinations of the various vehicles may be used. Rectal and vaginal suppositories may be prepared by the compressed method or molding. The typical weight of a rectal and vaginal suppository is about 2 to about 3 g.

Solutions or suspensions for use in a pressurized container, pump, spray, atomizer, or nebulizer may be formulated to contain ethanol, aqueous ethanol, or a suitable alternative agent for dispersing, solubilizing, or extending release of the active ingredient disclosed herein, a propellant as solvent; and/or a surfactant, such as sorbitan trioleate, oleic acid, or an oligolactic acid.

A pharmaceutical composition comprising a compound disclosed herein, a derivative or analog thereof, including pharmaceutical salt forms and prodrug forms, may be micronized to a size suitable for delivery by inhalation, such as about 50 micrometers or less, or about 10 micrometers or less. Particles of such sizes may be prepared using a comminuting method known to those skilled in the art, such as spiral jet milling, fluid bed jet milling, supercritical fluid processing to form nanoparticles, high pressure homogenization, or spray drying.

Capsules, blisters and cartridges for use in an inhaler or insufflator may be formulated to contain a powder mix of the pharmaceutical compositions disclosed herein; a suitable powder base, such as lactose or starch; and a performance modifier, such as 1-leucine, mannitol, or magnesium stearate. The lactose may be anhydrous or in the form of the monohydrate. Other suitable excipients or carriers include dextran, glucose, maltose, sorbitol, xylitol, fructose, sucrose, and trehalose. A pharmaceutical composition comprising a compound disclosed herein, a derivative or analog thereof, including pharmaceutical salt forms and prodrug forms, for inhaled/intranasal administration may further comprise a suitable flavor, such as menthol and levomenthol, or sweeteners, such as saccharin or saccharin sodium.

A pharmaceutical composition comprising a compound disclosed herein, a derivative or analog thereof, including pharmaceutical salt forms and prodrug forms, for topical administration may be formulated to be immediate release or modified release, including delayed-, sustained-, pulsed-, controlled-, targeted, and programmed release.

A pharmaceutical composition comprising a compound disclosed herein, a derivative or analog thereof, including pharmaceutical salt forms and prodrug forms, may be formulated into liposomes to reduce toxicity or increase bioavailability. Other methods for delivery include oral methods that entail encapsulation of the in microspheres or proteinoids, aerosol delivery (e.g., to the lungs), or transdermal delivery (e.g., by iontophoresis or transdermal electroporation). Other methods of administration will be known to those skilled in the art.

A pharmaceutical composition comprising a compound disclosed herein, a derivative or analog thereof, including pharmaceutical salt forms and prodrug forms, may be formulated as a modified release dosage form. As used herein, the term “modified release” refers to a dosage form in which the rate or place of release of the active ingredient(s) is different from that of an immediate dosage form when administered by the same route. Modified release dosage forms include delayed-, extended-, prolonged-, sustained-, pulsatile-, controlled-, accelerated- and fast-, targeted-, programmed-release, and gastric retention dosage forms. The pharmaceutical compositions in modified release dosage forms can be prepared using a variety of modified release devices and methods known to those skilled in the art, including, but not limited to, matrix controlled release devices, osmotic controlled release devices, multiparticulate controlled release devices, ion-exchange resins, enteric coatings, multilayered coatings, microspheres, liposomes, and combinations thereof. The release rate of the active ingredient(s) can also be modified by varying the particle sizes and polymorphorism of the active ingredient(s). Examples of modified release include, but are not limited to, those described in U.S. Pat. Nos. 3,845,770; 3,916,899; 3,536,809; 3,598,123; 4,008,719; 5,674,533; 5,059,595; 5,591,767; 5,120,548; 5,073,543; 5,639,476; 5,354,556; 5,639,480; 5,733,566; 5,739,108; 5,891,474; 5,922,356; 5,972,891; 5,980,945; 5,993,855; 6,045,830; 6,087,324; 6,113,943; 6,197,350; 6,248,363; 6,264,970; 6,267,981; 6,376,461; 6,419,961; 6,589,548; 6,613,358; and 6,699,500.

The pharmaceutical composition comprising a compound disclosed herein, a derivative or analog thereof, including pharmaceutical salt forms and prodrug forms, that is formulated in a modified release dosage form may be fabricated using a matrix controlled release device (see, Takada et al in “Encyclopedia of Controlled Drug Delivery,” Vol. 2, Mathiowitz ed., Wiley, 1999).

In one embodiment, the pharmaceutical composition comprising a compound disclosed herein, a derivative or analog thereof, including pharmaceutical salt forms and prodrug forms, in a modified release dosage form is formulated using an erodible matrix device, which is water-swellable, erodible, or soluble polymers, including synthetic polymers, and naturally occurring polymers and derivatives, such as polysaccharides and proteins.

Materials useful in forming an erodible matrix include, but are not limited to, chitin, chitosan, dextran, and pullulan; gum agar, gum arabic, gum karaya, locust bean gum, gum tragacanth, carrageenans, gum ghatti, guar gum, xanthan gum, and scleroglucan; starches, such as dextrin and maltodextrin; hydrophilic colloids, such as pectin; phosphatides, such as lecithin; alginates; propylene glycol alginate; gelatin; collagen; and cellulosics, such as ethyl cellulose (EC), methylethyl cellulose (MEC), carboxymethyl cellulose (CMC), CMEC, hydroxyethyl cellulose (HEC), hydroxypropyl cellulose (HPC), cellulose acetate (CA), cellulose propionate (CP), cellulose butyrate (CB), cellulose acetate butyrate (CAB), CAP, CAT, hydroxypropyl methyl cellulose (HPMC), HPMCP, HPMCAS, hydroxypropyl methyl cellulose acetate trimellitate (HPMCAT), and ethylhydroxy ethylcellulose (EHEC); polyvinyl pyrrolidone; polyvinyl alcohol; polyvinyl acetate; glycerol fatty acid esters; polyacrylamide; polyacrylic acid; copolymers of ethacrylic acid or methacrylic acid (EUDRAGIT, Rohm America, Inc., Piscataway, N.J.); poly(2-hydroxyethyl-methacrylate); polylactides; copolymers of L-glutamic acid and ethyl-L-glutamate; degradable lactic acid-glycolic acid copolymers; poly-D-(−)-3-hydroxybutyric acid; and other acrylic acid derivatives, such as homopolymers and copolymers of butylmethacrylate, methylmethacrylate, ethylmethacrylate, ethylacrylate, (2-dimethylaminoethyl)methacrylate, and (trimethylaminoethyl)methacrylate chloride.

In further embodiments, a pharmaceutical composition comprising a compound disclosed herein, a derivative or analog thereof, including pharmaceutical salt forms and prodrug forms are formulated with a non-erodible matrix device. The active ingredient(s) is dissolved or dispersed in an inert matrix and is released primarily by diffusion through the inert matrix once administered. Materials suitable for use as a non-erodible matrix device included, but are not limited to, insoluble plastics, such as polyethylene, polypropylene, polyisoprene, polyisobutylene, polybutadiene, polymethylmethacrylate, polybutylmethacrylate, chlorinated polyethylene, polyvinylchloride, methyl acrylate-methyl methacrylate copolymers, ethylene-vinylacetate copolymers, ethylene/propylene copolymers, ethylene/ethyl acrylate copolymers, vinylchloride copolymers with vinyl acetate, vinylidene chloride, ethylene and propylene, ionomer polyethylene terephthalate, butyl rubber epichlorohydrin rubbers, ethylene/vinyl alcohol copolymer, ethylene/vinyl acetate/vinyl alcohol terpolymer, and ethylene/vinyloxyethanol copolymer, polyvinyl chloride, plasticized nylon, plasticized polyethyleneterephthalate, natural rubber, silicone rubbers, polydimethylsiloxanes, silicone carbonate copolymers; hydrophilic polymers, such as ethyl cellulose, cellulose acetate, crospovidone, and cross-linked partially hydrolyzed polyvinyl acetate; and fatty compounds, such as carnauba wax, microcrystalline wax, and triglycerides.

In a matrix controlled release system, the desired release kinetics can be controlled, for example, via the polymer type employed, the polymer viscosity, the particle sizes of the polymer and/or the active ingredient(s), the ratio of the active ingredient(s) versus the polymer, and other excipients or carriers in the compositions.

A pharmaceutical composition comprising a compound disclosed herein, a derivative or analog thereof, including pharmaceutical salt forms and prodrug forms, in a modified release dosage form may be prepared by methods known to those skilled in the art, including direct compression, dry or wet granulation followed by compression, melt-granulation followed by compression.

The pharmaceutical composition comprising a compound disclosed herein, a derivative or analog thereof, including pharmaceutical salt forms and prodrug forms, in a modified release dosage form may be fabricated using an osmotic controlled release device, including one-chamber system, two-chamber system, asymmetric membrane technology (AMT), and extruding core system (ECS). In general, such devices have at least two components: (a) the core which contains the active ingredient(s) and (b) a semipermeable membrane with at least one delivery port, which encapsulates the core. The semipermeable membrane controls the influx of water to the core from an aqueous environment of use so as to cause drug release by extrusion through the delivery port(s).

In addition to the active ingredient(s), the core of the osmotic device optionally includes an osmotic agent, which creates a driving force for transport of water from the environment of use into the core of the device. One class of osmotic agents water-swellable hydrophilic polymers, which are also referred to as “osmopolymers” and “hydrogels,” including, but not limited to, hydrophilic vinyl and acrylic polymers, polysaccharides such as calcium alginate, polyethylene oxide (PEO), polyethylene glycol (PEG), polypropylene glycol (PPG), poly(2-hydroxyethyl methacrylate), poly(acrylic) acid, poly(methacrylic) acid, polyvinylpyrrolidone (PVP), crosslinked PVP, polyvinyl alcohol (PVA), PVA/PVP copolymers, PVA/PVP copolymers with hydrophobic monomers such as methyl methacrylate and vinyl acetate, hydrophilic polyurethanes containing large PEO blocks, sodium croscarmellose, carrageenan, hydroxyethyl cellulose (HEC), hydroxypropyl cellulose (HPC), hydroxypropyl methyl cellulose (HPMC), carboxymethyl cellulose (CMC) and carboxyethyl, cellulose (CEC), sodium alginate, polycarbophil, gelatin, xanthan gum, and sodium starch glycolate.

The other class of osmotic agents are osmogens, which are capable of imbibing water to affect an osmotic pressure gradient across the barrier of the surrounding coating. Suitable osmogens include, but are not limited to, inorganic salts, such as magnesium sulfate, magnesium chloride, calcium chloride, sodium chloride, lithium chloride, potassium sulfate, potassium phosphates, sodium carbonate, sodium sulfite, lithium sulfate, potassium chloride, and sodium sulfate; sugars, such as dextrose, fructose, glucose, inositol, lactose, maltose, mannitol, raffinose, sorbitol, sucrose, trehalose, and xylitol; organic acids, such as ascorbic acid, benzoic acid, fumaric acid, citric acid, maleic acid, sebacic acid, sorbic acid, adipic acid, edetic acid, glutamic acid, p-tolunesulfonic acid, succinic acid, and tartaric acid; urea; and mixtures thereof.

Osmotic agents of different dissolution rates may be employed to influence how rapidly the active ingredient(s) is initially delivered from the dosage form. For example, amorphous sugars, such as Mannogeme EZ (SPI Pharma, Lewes, Del.) can be used to provide faster delivery during the first couple of hours to promptly produce the desired therapeutic effect, and gradually and continually release of the remaining amount to maintain the desired level of therapeutic or prophylactic effect over an extended period of time. In this case, the active ingredient(s) is released at such a rate to replace the amount of the active ingredient metabolized and excreted.

The core may also include a wide variety of other excipients and carriers as described herein to enhance the performance of the dosage form or to promote stability or processing.

The total amount of the active ingredient(s) released and the release rate can substantially by modulated via the thickness and porosity of the semipermeable membrane, the composition of the core, and the number, size, and position of the delivery ports.

The pharmaceutical composition comprising a compound disclosed herein, a derivative or analog thereof, including pharmaceutical salt forms and prodrug forms, in an osmotic controlled-release dosage form may further comprise additional conventional excipients or carriers as described herein to promote performance or processing of the formulation.

The osmotic controlled-release dosage forms can be prepared according to conventional methods and techniques known to those skilled in the art (see, Remington: The Science and Practice of Pharmacy, supra; Santus and Baker, J. Controlled Release 1995, 35, 1-21; Verma et al., Drug Development and Industrial Pharmacy 2000, 26, 695-708; Verma et al., J. Controlled Release 2002, 79, 7-27).

In a certain embodiment, a pharmaceutical composition comprising a compound disclosed herein, a derivative or analog thereof, including pharmaceutical salt forms and prodrug forms are formulated as AMT controlled-release dosage form, which comprises an asymmetric osmotic membrane that coats a core comprising the active ingredient(s) and other pharmaceutically acceptable excipients or carriers. See, U.S. Pat. No. 5,612,059 and WO 2002/17918. The AMT controlled-release dosage forms can be prepared according to conventional methods and techniques known to those skilled in the art, including direct compression, dry granulation, wet granulation, and a dip-coating method.

In a particular embodiment, a pharmaceutical composition comprising a compound disclosed herein, a derivative or analog thereof, including pharmaceutical salt forms and prodrug forms are formulated as ESC controlled-release dosage form, which comprises an osmotic membrane that coats a core comprising the active ingredient(s), a hydroxylethyl cellulose, and other pharmaceutically acceptable excipients or carriers.

A pharmaceutical composition comprising a compound disclosed herein, a derivative or analog thereof, including pharmaceutical salt forms and prodrug forms, may be administered parenterally by injection, infusion, or implantation, for local or systemic administration. Parenteral administration, as used herein, include intravenous, intraarterial, intraperitoneal, intrathecal, intraventricular, intraurethral, intrastemal, intracranial, intramuscular, intrasynovial, and subcutaneous administration.

A pharmaceutical composition comprising a compound disclosed herein, a derivative or analog thereof, including pharmaceutical salt forms and prodrug forms, may be formulated in any dosage forms that are suitable for parenteral administration, including solutions, suspensions, emulsions, micelles, liposomes, microspheres, nanosystems, and solid forms suitable for solutions or suspensions in liquid prior to injection. Such dosage forms can be prepared according to conventional methods known to those skilled in the art of pharmaceutical science (see, Remington: The Science and Practice of Pharmacy, supra).

The pharmaceutical composition comprising a compound disclosed herein, a derivative or analog thereof, including pharmaceutical salt forms and prodrug forms, may include one or more pharmaceutically acceptable carriers and excipients, including, but not limited to, aqueous vehicles, water-miscible vehicles, non-aqueous vehicles, antibacterial agents or preservatives against the growth of microorganisms, stabilizers, solubility enhancers, isotonic agents, buffering agents, antioxidants, local anesthetics, suspending and dispersing agents, wetting or emulsifying agents, complexing agents, sequestering or chelating agents, cryoprotectants, lyoprotectants, thickening agents, pH adjusting agents, and inert gases.

Preparations for parenteral administration of a pharmaceutical composition comprising a compound disclosed herein, a derivative or analog thereof, including pharmaceutical salt forms and prodrug forms include sterile aqueous or non-aqueous solutions, suspensions, and emulsions. Suitable aqueous vehicles include, but are not limited to, water, saline, physiological saline or phosphate buffered saline (PBS), sodium chloride injection, Ringers injection, isotonic dextrose injection, sterile water injection, dextrose, lactated Ringers injection, alcoholic/aqueous solutions, and emulsions or suspensions. Non-aqueous vehicles include, but are not limited to, injectable organic esters such as ethyl oleate, and fixed oils of vegetable origin, castor oil, corn oil, cottonseed oil, olive oil, peanut oil, peppermint oil, safflower oil, sesame oil, soybean oil, hydrogenated vegetable oils, hydrogenated soybean oil, and medium-chain triglycerides of coconut oil, palm seed oil. Water-miscible vehicles include, but are not limited to, ethanol, 1,3-butanediol, liquid polyethylene glycol (e.g., polyethylene glycol 300 and polyethylene glycol 400), propylene glycol, glycerin, N-methyl-2-pyrrolidone, dimethylacetamide, and dimethylsulfoxide. Examples of parenteral vehicles include sodium chloride solution, Ringer's dextrose, dextrose and sodium chloride, lactated Ringer's, and fixed oils. Intravenous vehicles include fluid and nutrient replenishers, electrolyte replenishers (such as those based on Ringer's dextrose), and the like. Preservatives and other additives such as, other antibacterials, anti-oxidants, cheating agents, inert gases and the like also can be included.

Suitable antibacterial agents or preservatives that can be used with a compound of the disclosure include, but are not limited to, phenols, cresols, mercurials, benzyl alcohol, chlorobutanol, methyl and propyl p-hydroxybenzates, thimerosal, benzalkonium chloride, benzethonium chloride, methyl- and propyl-parabens, and sorbic acid. Suitable isotonic agents include, but are not limited to, sodium chloride, glycerin, and dextrose. Suitable buffering agents include, but are not limited to, phosphate and citrate. Suitable antioxidants are those as described herein, including bisulfate and sodium metabisulfite. Suitable local anesthetics include, but are not limited to, procaine hydrochloride. Suitable suspending and dispersing agents are those as described herein, including sodium carboxymethylcelluose, hydroxypropyl methylcellulose, and polyvinylpyrrolidone. Suitable emulsifying agents include those described herein, including polyoxyethylene sorbitan monolaurate, polyoxyethylene sorbitan monooleate 80, and triethanolamine oleate. Suitable sequestering or chelating agents include, but are not limited to EDTA. Suitable pH adjusting agents include, but are not limited to, sodium hydroxide, hydrochloric acid, citric acid, and lactic acid. Suitable complexing agents include, but are not limited to, cyclodextrins, including α-cyclodextrin, β-cyclodextrin, hydroxypropyl-β-cyclodextrin, sulfobutylether-β-cyclodextrin, and sulfobutylether 7-β-cyclodextrin (CAPTISOL®, CyDex, Lenexa, Kans.).

A pharmaceutical composition comprising a compound disclosed herein, a derivative or analog thereof, including pharmaceutical salt forms and prodrug forms may be formulated for single or multiple dosage administration. The single dosage formulations are packaged in an ampule, a vial, or a syringe. The multiple dosage parenteral formulations must contain an antimicrobial agent at bacteriostatic or fungistatic concentrations. Parenteral formulations are sterile, as known and practiced in the art.

In one embodiment, the pharmaceutical composition comprising a compound disclosed herein, a derivative or analog thereof, including pharmaceutical salt forms and prodrug forms are formulated as ready-to-use sterile solutions. In another embodiment, the pharmaceutical composition comprising a compound disclosed herein, a derivative or analog thereof, including pharmaceutical salt forms and prodrug forms are formulated as sterile dry soluble products, including lyophilized powders and hypodermic tablets, to be reconstituted with a vehicle prior to use. In yet another embodiment, the pharmaceutical composition comprising a compound disclosed herein, a derivative or analog thereof, including pharmaceutical salt forms and prodrug forms are formulated as ready-to-use sterile suspensions. In yet another embodiment, the pharmaceutical composition comprising a compound disclosed herein, a derivative or analog thereof, including pharmaceutical salt forms and prodrug forms are formulated as sterile dry insoluble products to be reconstituted with a vehicle prior to use. In still another embodiment, the pharmaceutical composition comprising a compound disclosed herein, a derivative or analog thereof, including pharmaceutical salt forms and prodrug forms are formulated as ready-to-use sterile emulsions.

It is especially advantageous to formulate parenteral compositions in dosage unit form for ease of administration and uniformity of dosage. “Dosage unit form” as used herein, refers to physically discrete units suited as unitary dosages for the individual to be treated; each unit containing a predetermined quantity of pharmaceutical composition is calculated to produce the desired therapeutic effect in association with the required pharmaceutical carrier. The specification for the dosage unit forms of the disclosure are related to the characteristics of the pharmaceutical composition and the particular therapeutic effect to be achieve.

A pharmaceutical composition comprising a compound disclosed herein, a derivative or analog thereof, including pharmaceutical salt forms and prodrug forms, suitable for injectable use include sterile aqueous solutions (where water soluble) or dispersions and sterile powders for the extemporaneous preparation of sterile injectable solutions or dispersions. In all cases, the pharmaceutical composition comprising a compound disclosed herein, a derivative or analog thereof, including pharmaceutical salt forms and prodrug forms, should be sterile and should be fluid to the extent that easy syringability exists. The carrier can be a solvent or dispersion medium containing, for example, water, ethanol, polyol (for example, glycerol, propylene glycol, and liquid polyetheylene glycol, and the like), suitable mixtures thereof, and vegetable oils. The proper fluidity can be maintained, for example, by the use of a coating, such as lecithin, by the maintenance of the required particle size, in the case of dispersion, and by the use of surfactants. Prevention of the action of microorganisms can be achieved by various antibacterial and antifungal agents, for example, parabens, chlorobutanol, phenol, ascorbic acid, thimerosal, and the like. In many cases, it will be typical to include isotonic agents, for example, sugars, polyalcohols, such as mannitol, sorbitol, or sodium chloride in the composition. Prolonged absorption of the injectable compositions can be brought about by including in the composition an agent that delays absorption, for example, aluminum monostearate and gelatin.

Sterile injectable solutions can be prepared by incorporating a pharmaceutical composition comprising a compound disclosed herein, a derivative or analog thereof, including pharmaceutical salt forms and prodrug form in the required amount in an appropriate solvent with one or a combination of ingredients enumerated above, as required, followed by filtered sterilization. Generally, dispersions are prepared by incorporating a pharmaceutical composition comprising a compound disclosed herein, a derivative or analog thereof, including pharmaceutical salt forms and prodrug forms, into a sterile vehicle that contains a basic dispersion medium and the required other ingredients from those enumerated above.

A pharmaceutical composition comprising a compound disclosed herein, a derivative or analog thereof, including pharmaceutical salt forms and prodrug forms, can be orally administered, for example, with an inert diluent or an assimilable edible carrier. The pharmaceutical composition comprising a compound disclosed herein, a derivative or analog thereof, including pharmaceutical salt forms and prodrug forms, and other ingredients can also be enclosed in a hard or soft-shell gelatin capsule, compressed into tablets, or incorporated directly into the individual's diet. For oral therapeutic administration, the pharmaceutical composition comprising a compound disclosed herein, a derivative or analog thereof, including pharmaceutical salt forms and prodrug forms, can be incorporated with excipients and used in the form of ingestible tablets, buccal tablets, troches, capsules, elixirs, suspensions, syrups, wafers, and the like. Such compositions and preparations should contain at least 1% by weight of active compound. The percentage of the compositions and preparations can, of course, be varied and can conveniently be between about 5% to about 80% of the weight of the unit.

The tablets, troches, pills, capsules, and the like can also contain the following: a binder, such as gum gragacanth, acacia, corn starch, or gelatin; excipients such as dicalcium phosphate; a disintegrating agent, such as corn starch, potato starch, alginic acid, and the like; a lubricant, such as magnesium stearate; and a sweetening agent, such as sucrose, lactose or saccharin, or a flavoring agent such as peppermint, oil of wintergreen, or cherry flavoring. When the dosage unit form is a capsule, it can contain, in addition to materials of the above type, a liquid carrier. Various other materials can be present as coatings or to otherwise modify the physical form of the dosage unit. For instance, tablets, pills, or capsules can be coated with shellac, sugar, or both. A syrup or elixir can contain the agent, sucrose as a sweetening agent, methyl and propylparabens as preservatives, a dye, and flavoring, such as cherry or orange flavor. Of course, any material used in preparing any dosage unit form should be pharmaceutically pure and substantially non-toxic/biocompatible in the amounts employed.

A pharmaceutical composition comprising a compound disclosed herein, a derivative or analog thereof, including pharmaceutical salt forms and prodrug forms are disclosed herein, may be formulated as immediate or modified release dosage forms, including delayed-, sustained-, pulsed-, controlled, targeted-, and programmed-release forms.

A pharmaceutical composition comprising a compound disclosed herein, a derivative or analog thereof, including pharmaceutical salt forms and prodrug forms are disclosed herein, may be formulated as a suspension, solid, semi-solid, or thixotropic liquid, for administration as an implanted depot. In one embodiment, the pharmaceutical composition comprising a compound disclosed herein, a derivative or analog thereof, including pharmaceutical salt forms and prodrug forms are dispersed in a solid inner matrix, which is surrounded by an outer polymeric membrane that is insoluble in body fluids but allows the active ingredient in the pharmaceutical compositions to diffuse through.

Suitable inner matrixes include polymethylmethacrylate, polybutylmethacrylate, plasticized or unplasticized polyvinylchloride, plasticized nylon, plasticized polyethyleneterephthalate, natural rubber, polyisoprene, polyisobutylene, polybutadiene, polyethylene, ethylene-vinylacetate copolymers, silicone rubbers, polydimethylsiloxanes, silicone carbonate copolymers, hydrophilic polymers, such as hydrogels of esters of acrylic and methacrylic acid, collagen, cross-linked polyvinylalcohol, and cross-linked partially hydrolyzed polyvinyl acetate.

Suitable outer polymeric membranes include polyethylene, polypropylene, ethylene/propylene copolymers, ethylene/ethyl acrylate copolymers, ethylene/vinylacetate copolymers, silicone rubbers, polydimethyl siloxanes, neoprene rubber, chlorinated polyethylene, polyvinylchloride, vinylchloride copolymers with vinyl acetate, vinylidene chloride, ethylene and propylene, ionomer polyethylene terephthalate, butyl rubber epichlorohydrin rubbers, ethylene/vinyl alcohol copolymer, ethylene/vinyl acetate/vinyl alcohol terpolymer, and ethylene/vinyloxyethanol copolymer.

A therapeutically effective amount can be measured as the amount sufficient to decrease a subject's symptoms (e.g., tumor growth, cancer spread and the like). Typically, the subject is treated with an amount of a therapeutic composition comprising a compound disclosed herein, a derivative or analog thereof, including pharmaceutical salt forms and prodrug forms, sufficient to reduce a symptom of a disease or disorder by at least 50%, 90% or 100%. Generally, the optimal dosage will depend upon the disorder and factors such as the weight of the subject, the type of cancer or neoplasm, the weight, sex, and degree of symptoms. Nonetheless, suitable dosages can readily be determined by one skilled in the art. Typically, a suitable dosage is 0.5 to 40 mg/kg body weight, e.g., 1 to 8 mg/kg body weight.

The compounds disclosed herein may also be combined or used in combination with other agents useful in the treatment, prevention, or amelioration of one or more symptoms of various syndromes, disorders, and/or diseases. Or, by way of example only, the therapeutic effectiveness of one of the compounds described herein may be enhanced by administration of an adjuvant (i.e., by itself the adjuvant may only have minimal therapeutic benefit, but in combination with another therapeutic agent, the overall therapeutic benefit to the patient is enhanced).

Such other agents, adjuvants, or drugs, may be administered, by a route and in an amount commonly used therefor, simultaneously (at the same time or in the same formulation) or sequentially with a compound as disclosed herein. When a compound as disclosed herein disclosed herein is used contemporaneously with one or more other drugs, a pharmaceutical composition containing such other drugs in addition to the compound disclosed herein may be utilized, but is not required. Accordingly, the pharmaceutical compositions disclosed herein include those that also contain one or more other active ingredients or therapeutic agents (e.g., a chemotherapeutic or other anti-cancer agent, an antibiotic, and the like), in addition to a compound disclosed herein.

Examples of chemotherapeutic agents include: alkylating agents such as thiotepa and CYTOXAN® cyclosphosphamide; alkyl sulfonates such as busulfan, improsulfan and piposulfan; aziridines such as benzodopa, carboquone, meturedopa, and uredopa; ethylenimines and methylamelamines including altretamine, triethylenemelamine, trietylenephosphoramide, triethiylenethiophosphoramide and tiimethylolomelamine; acetogenins (e.g., bullatacin and bullatacinone); a camptothecin (including the synthetic analogue topotecan); bryostatin; callystatin; CC-1065 (including its adozelesin, carzelesin and bizelesin synthetic analogues); cryptophycins (particularly cryptophycin 1 and cryptophycin 8); dolastatin; duocarmycin (including the synthetic analogues, KW-2189 and CB1-TM1); eleutherobin; pancratistatin; a sarcodictyin; spongistatin; nitrogen mustards such as chlorambucil, chlornaphazine, cholophosphamide, estramustine, ifosfamide, mechlorethamine, mechlorethamine oxide hydrochloride, melphalan, novembichin, phenesterine, prednimustine, trofosfamide, uracil mustard; nitrosureas such as carmustine, chlorozotocin, fotemustine, lomustine, nimustine, and ranimnustine; vinca alkaloids; epipodophyllotoxins; antibiotics such as the enediyne antibiotics (e.g., calicheamicin, especially calicheamicin gammall and calicheamicin omegall; L-asparaginase; anthracenedione substituted urea; methyl hydrazine derivatives; dynemicin, including dynemicin A; bisphosphonates, such as clodronate; an esperamicin; as well as neocarzinostatin chromophore and related chromoprotein enediyne antiobiotic chromophores), aclacinomysins, actinomycin, authramycin, azaserine, bleomycins, cactinomycin, carabicin, carminomycin, carzinophilin, chromomycinis, dactinomycin, daunorubicin, detorubicin, 6-diazo-5-oxo-L-norleucine, ADRIAMYCIN® doxorubicin (including morpholino-doxorubicin, cyanomorpholino-doxorubicin, 2-pyrrolino-doxorubicin and deoxydoxorubicin), epirubicin, esorubicin, idarubicin, marcellomycin, mitomycins such as mitomycin C, mycophenolic acid, nogalamycin, olivomycins, peplomycin, potfiromycin, puromycin, quelamycin, rodorubicin, streptonigrin, streptozocin, tubercidin, ubenimex, zinostatin, zorubicin; anti-metabolites such as methotrexate and 5-fluorouracil (5-FU); folic acid analogs such as denopterin, methotrexate, pteropterin, trimetrexate; purine analogs such as fludarabine, 6-mercaptopurine, thiamiprine, thioguanine; pyrimidine analogs such as ancitabine, azacitidine, 6-azauridine, carmofur, cytarabine, dideoxyuridine, doxifluridine, enocitabine, floxuridine; androgens such as calusterone, dromostanolone propionate, epitiostanol, mepitiostane, testolactone; anti-adrenals such as aminoglutethimide, mitotane, trilostane; folic acid replenisher such as frolinic acid; aceglatone; aldophosphamide glycoside; aminolevulinic acid; eniluracil; amsacrine; bestrabucil; bisantrene; edatraxate; defofamine; demecolcine; diaziquone; elfornithine; elliptinium acetate; an epothilone; etoglucid; gallium nitrate; hydroxyurea; lentinan; lonidainine; maytansinoids such as maytansine and ansamitocins; mitoguazone; mitoxantrone; mopidanmol; nitiaerine; pentostatin; phenamet; pirarubicin; losoxantione; podophyllinic acid; 2-ethylhydrazide; procarbazine; PSK® polysaccharide complex (JHS Natural Products, Eugene, Oreg.); razoxane; rhizoxin; sizofiran; spirogermanium; tenuazonic acid; triaziquone; 2,2 2″-trichlorotiiethylamine; trichothecenes (especially T-2 toxin, verracurin A, roridin A and anguidine); urethan; vindesine; dacarbazine; mannomustine; mitobronitol; mitolactol; pipobroman; gacytosine; arabinoside (“Ara-C”); cyclophosphamide; thiotepa; taxoids, e.g., TAXOL® paclitaxel (Bristol-Myers Squibb Oncology, Princeton, N.J.), ABRAXANE® Cremophor-free, albumin-engineered nanoparticle formulation of paclitaxel (American Pharmaceutical Partners, Schaumberg, Ill.), and TAXOTERE® (docetaxel) (Rhone-Poulenc Rorer, Antony, France); chloranbucil; GEMZAR® (gemcitabine); 6-thioguanine; mercaptopurine; methotrexate; platinum coordination complexes such as cisplatin, oxaliplatin and carboplatin; vinblastine; platinum; etoposide (VP-16); ifosfamide; mitoxantrone; vincristine; NAVELBINE® vinorelbine; novantrone; teniposide; edatrexate; daunomycin; aminopterin; xeloda; ibandronate; irinotecan (e.g., CPT-11); topoisomerase inhibitor RFS 2000; difluoromethylornithine (DFMO); retinoids such as retinoic acid; capecitabine; leucovorin (LV); irenotecan; adrenocortical suppressant; adrenocorticosteroids; progestins; estrogens; androgens; gonadotropin-releasing hormone analogs; and pharmaceutically acceptable salts, acids or derivatives of any of the above. Also included in this definition are anti-hormonal agents that act to regulate or inhibit hormone action on tumors such as antiestrogens and selective estrogen receptor modulators (SERMs), including, for example, tamoxifen (including NOLVADEX® tamoxifen), raloxifene, droloxifene, 4-hydroxytamoxifen, trioxifene, keoxifene, LY117018, onapristone, and FARESTON-toremifene; aromatase inhibitors that inhibit the enzyme aromatase, which regulates estrogen production in the adrenal glands, such as, for example, 4(5)-imidazoles, aminoglutethimide, MEGASE® megestrol acetate, AROMASL® exemestane, formestanie, fadrozole, RIVISOR® vorozole, FEMARA® letrozole, and ARTMIDEX® anastrozole; and antiandrogens such as flutamide, nilutamide, bicalutamide, leuprolide, and goserelin; as well as troxacitabine (a 1,3-dioxolane nucleoside cytosine analog); antisense oligonucleotides, particularly those which inhibit expression of genes in signaling pathways implicated in abherant cell proliferation, such as, for example, PKC-alpha, Ralf and H-Ras; ribozymes such as a VEGF-A expression inhibitor (e.g., ANGIOZYME® ribozyme) and a HER2 expression inhibitor; vaccines such as gene therapy vaccines, for example, ALLOVECTIN® vaccine, LEUVECTIN® vaccine, and VAXID® vaccine; PROLEUKIN® rJL-2; LURTOTECAN® topoisomerase 1 inhibitor; ABARELLX® rmRH; antibodies such as trastuzumab and pharmaceutically acceptable salts, acids or derivatives of any of the above.

Suitable antibiotics include aminoglycosides (e.g., gentamicin), beta-lactams (e.g., penicillins and cephalosporins), quinolones (e.g., ciprofloxacin), and novobiocin. Generally, the antibiotic is administered in a bactericidal, antiviral and/or antifungal amount. In a certain embodiment, a compound disclosed herein can be combined with one or more antibiotics, including, but not limited to, amoxicillin, ampicillin, arsphenamine, azithromycin, aztreonam, azlocillin, bacitracin, carbenicillin, cefaclor, cefadroxil, cefamandole, cefazolin, cephalexin, cefdinir, cefditorin, cefepime, cefixime, cefoperazone, cefotaxime, cefoxitin, cefpodoxime, cefprozil, ceftazidime, ceftibuten, ceftizoxime, ceftriaxone, cefuroxime, chloramphenicol, cilastin, ciprofloxacin, clarithromycin, clindamycin, clofazimine, cloxacillin, colistin, dalfopristan, demeclocycline, dicloxacillin, dirithromycin, doxycycline, erythromycin, enafloxacin, enviomycin, ertepenem, ethambutol, flucloxacillin, fosfomycin, furazolidone, gatifloxacin, geldanamycin, gentamicin, herbimicin, imipenem, linezolid, lomefloxacin, loracarbef, mafenide, moxifloxacin, meropenem, metronidazole, mezlocillin, minocycline, mupirozin, nafcillin, neomycin, netilmicin, nitrofurantoin, norfloxacin, oxytetracycline, penicillin, piperacillin, platensimycin, polymixin B, prochlorperazine, prontocil, quinupristine, rifabutin, roxithromycin, spectinomycin, sulfacetamide, sulfamethizole, sulfamethoxazole, teicoplanin, telithromycin, tetracycline, thioacetazone, thioridazine, ticarcillin, tobramycin, trimethoprim, troleandomycin, trovafloxacin, and vancomycin.

In yet a further embodiment, a compound provided herein can be combined with one or more steroidal drugs known in the art, including, but not limited to, aldosterone, beclometasone, betamethasone, deoxycorticosterone acetate, fludrocortisone acetate, hydrocortisone (cortisol), prednisolone, prednisone, methylprenisolone, dexamethasone, and triamcinolone.

In certain embodiments, a compound disclosed herein can be combined with one or more anti-fungal agents, including, but not limited to, amorolfine, amphotericin B, anidulafungin, bifonazole, butenafine, butoconazole, caspofungin, ciclopirox, clotrimazole, econazole, fenticonazole, filipin, fluconazole, isoconazole, itraconazole, ketoconazole, micafungin, miconazole, naftifine, natamycin, nystatin, oxyconazole, ravuconazole, posaconazole, rimocidin, sertaconazole, sulconazole, terbinafine, terconazole, tioconazole, and voriconazole.

The compounds disclosed herein can also be administered in combination, preferably sequentially, with other classes of compounds, including, but not limited to, antipruritics; anticoagulants, such as bivalirudin; thrombolytics, such as streptokinase; non-steroidal anti-inflammatory agents, such as aspirin; antiplatelet agents, such as clopidogrel; norepinephrine reuptake inhibitors (NRIs) such as atomoxetine; dopamine reuptake inhibitors (DARIs), such as methylphenidate; serotonin-norepinephrine reuptake inhibitors (SNRIs), such as milnacipran; sedatives, such as diazepham; norepinephrine-dopamine reuptake inhibitor (NDRIs), such as bupropion; serotonin-norepinephrine-dopamine-reuptake-inhibitors (SNDRIs), such as venlafaxine; monoamine oxidase inhibitors, such as selegiline; hypothalamic phospholipids; endothelin converting enzyme (ECE) inhibitors, such as phosphoramidon; opioids, such as tramadol; thromboxane receptor antagonists, such as ifetroban; potassium channel openers; thrombin inhibitors, such as hirudin; growth factor inhibitors, such as modulators of PDGF activity; platelet activating factor (PAF) antagonists; anti-platelet agents, such as GPIIb/IIIa blockers (e.g., abdximab, eptifibatide, and tirofiban), P2Y(AC) antagonists (e.g., clopidogrel, ticlopidine and CS-747), and aspirin; anti-coagulants, such as warfarin; low molecular weight heparins, such as enoxaparin; Factor VIa Inhibitors and Factor Xa Inhibitors; renin inhibitors; neutral endopeptidase (NEP) inhibitors; vasopepsidase inhibitors (dual NEP-ACE inhibitors), such as omapatrilat and gemopatrilat; HMG CoA reductase inhibitors, such as pravastatin, lovastatin, atorvastatin, simvastatin, NK-104 (a.k.a. itavastatin, nisvastatin, or nisbastatin), and ZD-4522 (also known as rosuvastatin, or atavastatin or visastatin); squalene synthetase inhibitors; fibrates; bile acid sequestrants, such as questran; niacin; anti-atherosclerotic agents, such as ACAT inhibitors; MTP Inhibitors; calcium channel blockers, such as amlodipine besylate; potassium channel activators; alpha-adrenergic agents; diuretics, such as chlorothlazide, hydrochiorothiazide, flumethiazide, hydroflumethiazide, bendroflumethiazide, methylchlorothiazide, trichioromethiazide, polythiazide, benzothlazide, ethacrynic acid, tricrynafen, chlorthalidone, furosenilde, musolimine, bumetanide, triamterene, amiloride, and spironolactone; thrombolytic agents, such as tissue plasminogen activator (tPA), recombinant tPA, streptokinase, urokinase, prourokinase, and anisoylated plasminogen streptokinase activator complex (APSAC); anti-diabetic agents, such as biguanides (e.g. metformin), glucosidase inhibitors (e.g., acarbose), insulins, meglitinides (e.g., repaglinide), sulfonylureas (e.g., glimepiride, glyburide, and glipizide), thiozolidinediones (e.g. troglitazone, rosiglitazone and pioglitazone), and PPAR-gamma agonists; mineralocorticoid receptor antagonists, such as spironolactone and eplerenone; growth hormone secretagogues; aP2 inhibitors; phosphodiesterase inhibitors, such as PDE III inhibitors (e.g., cilostazol) and PDE V inhibitors (e.g., sildenafil, tadalafil, vardenafil); protein tyrosine kinase inhibitors; anti-inflammatories; anti-proliferatives, such as methotrexate, FK506 (tacrolimus, Prograf), mycophenolate mofetil; chemotherapeutic agents; immunosuppressants; anticancer agents and cytotoxic agents (e.g., alkylating agents, such as nitrogen mustards, alkyl sulfonates, nitrosoureas, ethylenimines, and triazenes); anti-metabolites, such as folate antagonists, purine analogues, and pyrridine analogues; antibiotics, such as anthracyclines, bleomycins, mitomycin, dactinomycin, and plicamycin; enzymes, such as L-asparaginase; farnesyl-protein transferase inhibitors; hormonal agents, such as glucocorticoids (e.g., cortisone), estrogens/antiestrogens, androgens/antiandrogens, progestins, and luteinizing hormone-releasing hormone anatagonists, and octreotide acetate; microtubule-disruptor agents, such as ecteinascidins; microtubule-stablizing agents, such as pacitaxel, docetaxel, and epothilones A-F; plant-derived products, such as vinca alkaloids, epipodophyllotoxins, and taxanes; and topoisomerase inhibitors; prenyl-protein transferase inhibitors; and cyclosporins; cytotoxic drugs, such as azathiprine and cyclophosphamide; TNF-alpha inhibitors, such as tenidap; anti-TNF antibodies or soluble TNF receptor, such as etanercept, rapamycin, and leflunimide; and cyclooxygenase-2 (COX-2) inhibitors, such as celecoxib and rofecoxib; and miscellaneous agents such as, hydroxyurea, procarbazine, mitotane, hexamethylmelamine, gold compounds, platinum coordination complexes, such as cisplatin, satraplatin, and carboplatin.

The disclosure provides a method for inhibiting a cancer and/or neoplastic disorders by contacting or administering a therapeutically effective amount of a compound disclosed herein, derivative or analog thereof either alone or in combination with other anticancer agents to a subject who has, or is at risk of having, such a disorder. The term “inhibiting” means preventing or ameliorating a sign or symptoms of a syndrome, disorder, and/or disease (e.g., tomor growth, cancer cell proliferation and/or migration, cancer cell metastasis, and the like).

The disclosure also provides a method for inhibiting the growth of a tumor or cancer by contacting the tumor cells, cancer cells or neoplastic cells with a compound, derivative or analog thereof, including pharmaceutical salt and prodrug forms, with an inhibiting effective amount. The term “contacting” refers to exposing the cells (e.g., tumor, cancer or neoplastic cell) to an agent. Contacting of an organism with a topical probiotic composition of the disclosure can occur in vitro, for example, by adding the topical probiotic composition to a bacterial culture to test for susceptibility of the bacteria. Alternatively, contacting can occur in vivo, for example by contacting the topical probiotic composition with a subject afflicted with a bacterial infection, a subject susceptible to infection or a subject suffering from or at risk of developing a cancer.

Contacting can occur in vivo, for example, by administering the compound, derivative or analog thereof, including pharmaceutical salt and prodrug forms, to a subject afflicted with an infection, a tumor, cancer or neoplasm. In vivo contacting includes both parenteral as well as topical. “Inhibiting” or “inhibiting effective amount” refers to the amount of agent that is sufficient to cause, for example, tumor, cancer or neoplastic cell death, inhibition of growth and/or migration and/or inhibition of prevention of metastasis.

For use in the therapeutic applications described herein, kits and articles of manufacture are also described herein. Such kits can comprise a carrier, package, or container that is compartmentalized to receive one or more containers such as vials, tubes, and the like, each of the container(s) comprising one of the separate elements to be used in a method described herein. Suitable containers include, for example, bottles, vials, syringes, and test tubes. The containers can be formed from a variety of materials such as glass or plastic.

For example, the container(s) can comprise one or more compounds described herein, optionally in a composition or in combination with another agent as disclosed herein. The container(s) optionally have a sterile access port (for example the container can be an intravenous solution bag or a vial having a stopper pierceable by a hypodermic injection needle). Such kits optionally comprise a compound disclosed herein with an identifying description or label or instructions relating to its use in the methods described herein.

A kit will typically comprise one or more additional containers, each with one or more of various materials (such as reagents, optionally in concentrated form, and/or devices) desirable from a commercial and user standpoint for use of a compound described herein. Non-limiting examples of such materials include, but are not limited to, buffers, diluents, filters, needles, syringes; carrier, package, container, vial and/or tube labels listing contents and/or instructions for use, and package inserts with instructions for use. A set of instructions will also typically be included.

A label can be on or associated with the container. A label can be on a container when letters, numbers or other characters forming the label are attached, molded or etched into the container itself; a label can be associated with a container when it is present within a receptacle or carrier that also holds the container, e.g., as a package insert. A label can be used to indicate that the contents are to be used for a specific therapeutic application. The label can also indicate directions for use of the contents, such as in the methods described herein. These other therapeutic agents may be used, for example, in the amounts indicated in the Physicians' Desk Reference (PDR) or as otherwise determined by one of ordinary skill in the art.

The disclosure also provides method of identifying commensal bacteria that can produce 6-HAP comprising determining the presence of or expression of one or more of the sequences of Table 2 (i.e., SEQ ID Nos: 1, 3, 5, 7, 9, 11, 13, 15, 17, 19, 21, 23, 25, 27, 29, 31, 33, 35, 37, 39, 41, 43, 45, 47, 49, 51, 53, and/or 55) or sequences that are at least 98% identical thereto. Method of determining identity and homology are incredibly well known in the art and have been performed for at least the past 20 years. Detecing expression of a gene can be determined by quantitative RT-PCR, southern blot, norther blot etc. Microorganisms that have an expressin profile similar to S. epidermidis strains MO34 and/or MO38 and containing or expression sequence of SEQ ID NO: 1, 3, 5, 7, 9, 11, 13, 15, 17, 19, 21, 23, 25, 27, 29, 31, 33, 35, 37, 39, 41, 43, 45, 47, 49, 51, 53, and/or 55 can be used in the methods and compositions of the disclosure.

The disclosure also provide a diagnostic to determine risk or presence of skin cancer. The method comprising obtaining a microbiome sample from the skin of a subject at risk of or having skin cancer and measuring the production of a compound of formula I or II or identifying bacteria in the microbiome that produce a compound of of formula I or II, wherein the presence of a compound of formula I or II or a bacteria that produces a compound of formula I or II is indicative of a cancer or risk of developing cancer. In one embodiment, the subject is a human subject. In another embodiment, the method comprises identifying the presence of a S. epidermidis strain. In another embodiment, the S. epidermidis strain has the phenotype of ATCC Number _(——————) (strain designation S. epi-MO38 UCSD 20180315) and/or ATCC Number _(——————) (strain designation S. epi-MO34 UCSD 20180315).

The invention is further illustrated by the following examples:

EXAMPLES

Bacteria.

Clinical strains of S. epidermidis were isolated from the skin surface of healthy donors who had no contact with hospitals over 6 months. All strains were characterized by coagulase and catalase activities on rabbit plasma. S. epidermidis strains were further characterized using API-Staph (BIOMÉRIEUX Inc., Lyon, France) and by full-length 16SrRNA gene sequence. S. epidermidis (ATCC12228 and ATCC1457), S. aureus (ATCC35556), S. hominis (ATCC27844) E. coli (ATCC25922) and P. aeruginosa (ATCC14213) were obtained from American Type Culture Collection (Manassas, Va.). GAS (NZ131), GBS (DK23) and MRSA (USA300 and Sanger252) were generously gifted.

Characterization and purification of 6-HAP.

S. epidermidis MO34 strain was cultured in tryptic soy broth (TSB) at 37° C. for 24 hrs and was removed from culture supernatant with 0.22 μm filter. The filtrated culture supernatant was lyophilized and the residue was suspended in methanol to precipitate proteins. The supernatant was dried under vacuum and the residual substance was dissolved in water. As 6-HAP is weakly retained C18 reverse phase column, the solution was applied on Sep-Pak cartridge (Waters Co., Milford, Mass.) and washed with H₂O, and eluted with 5% acetonitrile in H₂O. The elution was lyophilized and suspended in 90% acetonitrile/10% water. The supernatant was separated by HPLC. After each purification step, activity was determined by radial diffusion assay against GAS (NZ131). Purified compound was characterized by Mass Spectrometory and NMR. The purified 6-HAP was lyophilized and dry weight was measured to measure specific activity.

Antimicrobial assays.

Radial diffusion assay was performed using GAS (NZ131) strain. Briefly, melted Todd-Hewitt broth (THB) agar (10 mL) was mixed with GAS [1×10⁶ colony forming unit (CFU)] and poured in a 10 cm petri dish. Two to four μL of test samples was applied in a small well punched on the agar plate. Plates were incubated at 37° C. overnight to allow visible growth of bacteria. Antibacterial activity was indicated by the clear zone (no bacterial growth) around the well.

To determine MBC, bacteria were cultured in TSB (Staphylococcus), THB (streptococcus) or Nutrient broth (P. aeruginosa and E. coli) by reaching exponential phase (OD₆₀₀=0.5-0.8). MBC of 6-HAP was determined by incubating 1×10⁵ CFU/mL bacteria with 2-fold serial dilutions of synthetic 6-HAP in half strength Muller-Hinton broth (MHB) in PBS at 37° C. for 24 hrs. After incubation, the number of viable bacteria was measured by counting CFU after spreading 10-fold serial dilutions of bacteria on suitable agar plates. MBC was determined as a 3-log reduction (99.9%) of viable bacteria after 24 hour incubation.

BrdU Incorporation Assay.

GAS (NZ131) or S. epidermidis (ATCC12228) were cultured in THB or TSB, respectively, by reaching exponential phase. The bacteria (1×10⁶ CFU) were incubated in 1004 of THB or TSB containing 10 μM BrdU, and 25 μg/mL 6-HAP or 5 μg/mL mitomycin C at 37° C. until 60 min. After incubation, bacteria cells were immediately fixed FixDenat solution (Roche, Mannheim, Germany). BrdU incorporation into nascent DNA was measured in a time-dependent manner using BrdU incorporation assay kit (Roche) according to the manual.

In Vitro DNA Polymerization Assay.

To examine if 6-HAP disrupts adenosine-thymidine base pair matching in DNA extension, IRDye800-labeled 18-bp primer and 25-bp template which required adenosine (X=T) or cytidine (X=G) at the initial base of overhang for extension were designed (FIG. 3e ). The reaction mixture contained 100 nM primer/template, 0.1 U Klenow fragment (exo⁻) DNA polymerase (Promega, Madison, Wis.), 1 μM dNPTs in DNA polymerase buffer. The mixture was incubated at 37° C. for 10 min. The reaction was terminated by adding stop solution (98% formaldehyde and 20 mM EDTA). The extended DNA was separated from primer by electrophoresis on a 20% denaturing polyacrylamide gel containing 7 M urea. Fluorescence was visualized with Oddyssey Imaging System (LI-COR Biosciences, Lincoln, Nebr.).

Cell Culture and Cell Proliferation Assay.

B16F10 mouse melanoma, Pam212, L5178 and YAC-1 mouse melanoma cell lines were obtained from American Type Culture Collection. Pam212, L5178 and YAC-1 cell lines were maintained in RPMI-1640 supplemented with sodium pyruvate (1 mM), nonessential amino acids (0.1 mM), penicillin (100 unit/mL), streptomycin (100 μg/mL) and 10% heat-inactivated fetal bovine serum (FBS) or horse serum at 37° C. under atmosphere of 5% (v/v) CO₂ in air. B16F10 cell line was maintained in DMEM supplemented with penicillin (100 unit/mL), streptomycin (100 μg/mL) and 10% heat-inactivated FBS. NHEKs were obtained from Invitrogen (Life technologies, Grand Island, N.Y.) and maintained in EpiLife medium (Life technologies) supplemented with 60 μM Calcium, epidermal growth factors, penicillin and streptomycin. After 4-hr (tumor cell lines) or 24-hr (NHEK) incubation with 6-HAP, proliferative activity of cells was colorimetrically determined by monitoring BrdU incorporation with Cell Proliferation kit according to the manual (Roche).

Gene Silencing of mARCs with siRNA.

NHEK was cultured in EpiLife® media containing pre-designed siRNA for mARC1 or mARC2 (Thermo Fisher, Waltham, Mass.), and RNAiMAX® reagent for 24 hrs. Cells were maintained in EpiLife for 72 hrs, and incubated with 6-HAP (10 μg/mL) for 24 hrs. Anti-proliferative activity of 6-HAP was determined by measuring BrdU incorporation as described above.

HPLC.

The active fraction from SepPak cartridge was separated by HPLC in a hydrophilic interaction mode with Venusil XBP NH2 (5 μm, 100 Å, 10×250 mm) (Agela Technologies, Wilmington, Del.) with a linier gradient of H₂O from 5% to 35% in acetonitrile at 4 mL/min. The active fraction was fractionated, lyophilized and dissolved in 90% acetonitrile in H₂O. The active fraction was further cleaned with PolyHYDROXYETHYL A (5 μm, 60 Å, 9.4×250 mm) with a linier gradient of H₂O from 5% to 35% in acetonitrile at 3 ml/min. Elution profile was monitored with absorbance at 270 nm. After each purification step, activity was determined by radial diffusion assay against GAS (NZ131). The purified 6-HAP was lyophilized and dry weight was measured to measure specific activity.

Mass Spectrometry.

A Thermo Finnigan MAT900XL mass spectrometer (Thermo Scientific, Waltham, Mass.) was employed for both low resolution electron impact mass spectrometry (LR-EI-MS) analysis and high resolution electrospray ionization mass spectrometry (HR-EI-MS) using direct insertion probe for sample introduction. The electron energy was set at 70 eV with an emission current of 1.0 mA. High resolution electrospray ionization MS (HR-ESI-MS) analysis was performed on a Thermo LTQ Orbitrap XL mass spectrometer. The source voltage was set at 4500 V with a heated capillary temperature of 250° C. and a sheath gas flow rate of 60 units.

¹H-NMR.

¹H NMR spectra of 6-HAP were recorded on a Mercury Plus 500 MHz Varian instrument. Chemical shifts (δ) are quoted in parts per million (ppm) referenced to the appropriate residual solvent peak (DMSO-d6 or D2O), with abbreviations s and br s denoting singlet and broad singlet. The 1H NMR spectrum of 6-HAP in AcOD-D2O (1:5 v/v) displayed two proton signals in the aromatic region, whereas six signals in DMSO-d6. 1H NMR (500 MHz, AcOD-D2O) δ 8.19 (s, 1H), 8.17 (s, 1H). 1H NMR (500 MHz, DMSO-d6) δ 12.74 (br s, 1H), 10.87 (br s, 0.7H), 9.50 (br s, 1H), 8.08 (br s, 1H), 7.75 (br s, 1H), 7.48 (br s, 0.4H).

Synthesis of 6-HAP.

6-HAP was prepared according to the previous reported procedure with slight modifications (Preparation of nucleobases and nucleosides as antiparasitic agents, Loakes, D.; Too, K., PCT Int. Apl., 2007135380, 29 Nov. 2007). Hydroxylamine hydrochloride (1.20 g, 17.3 mmole) was dissolved in 20 mL of boiling absolute ethanol and a solution of potassium hydroxide (1.12 g, 20.0 mmole) in 4 mL of hot absolute ethanol was added. The precipitated KCl was filtered and washed three times with 2 mL of hot ethanol. Then, 6-chloropurine (300 mg, 1.94 mmole) (Sigma, St. Louis, Mo.), dissolved in 7 mL of absolute ethanol, was added to the hydroxylamine solution. The reaction was refluxed for 2 hours then cooled to room temperature and allowed to stand overnight. The white precipitate formed was filtered and washed thoroughly with water and then ethanol, and dried under high vacuum to provide 6-HAP (230 mg, 78%) as a white solid. ¹H NMR (500 MHz, DMSO-d6) δ 12.84 (br s, 1H), 10.92 (br s, 0.5H), 9.48 (br s, 1H), 8.08 (br s, 0.6H), 7.77 (s, 1H), 7.48 (br s, 0.7), in agreement with those reported. The generated 6-HAP was purified by HPLC using Venusil XBP NH2 and PolyHYDROXYETHYL A as described above.

Animals.

All experiments involving animal work were in accordance with the approval of the Institutional Animal Care and Use Guidelines of the University of California San Diego (Protocol number: S09074).

In Vivo Skin Infection Assay.

Dorsal skin of C57BL6 mouse (6-8 weeks female) was shaved, treated with depilatory cream and rinsed with water at least 24 hrs before bacteria application. The shaved skin was cleaned with alcohol swab twice to remove originally colonized bacteria. S. epidermidis (MO34 or ATCC1457) were cultured in TSB overnight, washed with PBS, and then re-suspended in PBS. GAS (NZ131) and MRSA (Sanger252) were cultured in THB or TSB, respectively, until exponential phase (OD600=0.5-0.8), washed and re-suspended in PBS. Mouse dorsal skin (2×2 cm) was applied with either strain of S. epidermidis (1×10⁸ CFU/10 μL) or PBS (10 μL) for 2 hrs. GAS or MRSA (1×10⁵ CFU/104) were epicutaneously challenged on the dorsal skin for 6 hrs. Live bacteria were harvested with a Catch-All Swab (Epicentre Biotechnologies, Madison, Wis.) pre-wetted with TSB or THB from the skin surface (2×2 cm). Bacteria were suspended by vortex swab head vigorously in 1 mL THB or TSB. Ten-fold serial dilution of the bacteria suspension was spread on a blood agar plate or mannitol salt agar plate to count CFU. GAS (hemolytic) were distinguished from S. epidermidis (non-hemolytic) on a blood agar plate and MRSA (mannitol positive: a large yellow colony) were distinguished from S. epidermidis (mannitol negative: a small pink colony) on a mannitol salt agar plate.

For subcutaneous infection, mouse dorsal skin was subcutaneously injected with GAS (1×10⁷ CFU/50 μL in PBS) by 31G needle. The mice were intravenously injected with 6-HAP at a dose of 20 mg/kg weight or equal volume of vehicle (2.5% DMSO in 0.9% NaCl) after GAS infection. Wound development was monitored everyday by taking photographs along with a wound ruler and lesion size was measured with ImageJ ([http://]rsbweb.nih.gov/ij/)(hyperlink disabled by brackets).

In Vivo Tumor Growth Assay.

B16F10 were suspended in sterile PBS. Shaved mouse dorsal skin was intradermally injected with 3×10⁵ cells/50 μL. The C57BL6 mice were subsequently injected with 6-HAP dissolved in 2.5% DMSO/0.9% NaCl solution (40 mg/mL) at the dose of 20 mg/kg mouse via intravascular route every 48 hrs for 2 weeks. Control mice received an equal volume of vehicle. Tumor size was measured as the two perpendicular diameters with a caliper and volume was estimated by a formula, width²×length/2. The mice were sacrificed when tumor size reached >2 cm according to the animal protocol.

UV-Induced Tumor Formation in SKH-1 Mice.

Female SKH-1 hairless mice (4-week old) were purchased from Charles River Laboratories (Wilmington, Mass.). The back skin of mouse was topically treated with a single application of DMBA (200 nmoles/100 μL acetone) as a tumor initiator. A week after tumor initiation mice were irradiated with 180 mJ/cm² of UV-B twice a week, and were simultaneously treated with epicutaneous application with live S. epidermidis MO34 or ATCC1457 strain (1×10⁷ CFU) 6 times a week for 12 weeks. Tumor incidence and tumor number in each mouse were recoded every week.

Statistic Analysis.

Statistical analyses were performed using GraphPad Prism 5 software (GraphPad, La Jolla, Calif.). Independent t-test was used. Independent two-tailed t-tests were used to compare experimental and control groups for significance of differences (P<0.05).

S. epidermidis Strains from Human Skin Produce Non-Proteinaceous Antibiotic.

To screen for commensal skin bacteria producing antimicrobial activity, 44 strains of S. epidermidis from clinical isolates of normal human skin were cultured overnight and the antimicrobial activity produced by each isolate was determined by radial diffusion assay of their conditioned media against GAS (FIG. 1a ). Thirty three strains produced detectable zone of GAS growth inhibition. The S. epidermidis ATCC1457 strain did not show activity and was used as a negative control. Some specific strains, named as MO34 and MO38, produced the largest zone of GAS growth inhibition and were selected first to characterize the most potent antimicrobial molecules.

To characterize the molecule(s) responsible for antimicrobial activity secreted from the MO34 strain, the antimicrobial molecule was purified from the conditioned media based on activity against GAS. A single peak was isolated in the last chromatography of 5 purification steps (FIG. 1b ). The final yield of purified compound was 7 mg from 6.4 L culture supernatant. This purified fraction showed strong zones of inhibition of GAS growth, and was found only in the culture supernatant of MO34 and MO38 strains, but not in laboratory strains such as ATCC12228 and ATCC1457 strains (FIG. 9). This antimicrobial molecule was heat-stable (FIG. 1c ) and protease-insensitive (FIG. 1d ), thus suggesting the activity may not be a protein.

Skin Colonization by Antimicrobial S. epidermidis Strains Protects Against Pathogens.

To examine the physiological relevance of colonization by the strains of S. epidermidis that produce non-proteinaceous antibiotic on the skin surface, MO34 or a control strain of S. epidermidis without detectable antimicrobial activity (ATCC1457) (FIG. 1a ), or the vehicle alone, was applied to the surface of mouse dorsal skin. 2 hrs after application this site was then challenged with defined amounts of GAS or MRSA. Skin colonized by the antimicrobial strain inhibited growth of the pathogens within 6 hrs, but skin colonized by the control strain or vehicle did not (FIGS. 2a and b ). These data suggest that colonization by this antimicrobial S. epidermidis strains is protective against microbial pathogens on the skin surface.

Structural Analyses of Antibiotic Produced by S. epidermidis.

High-resolution electrospray (ES)-mass spectrometry analysis of the purified antimicrobial fraction identified a molecule with a mass of 151.0487, predicting a molecular formula of C₅H₅N₅O (calculated: 151.0489) (FIG. 3a ). When S. epidermidis was cultured in the presence of ammonium-¹⁵N chloride, the isotope was incorporated into the nitrogen atoms of this molecule, indicating that it was produced via de novo synthesis, but not by fermentation or breakdown of components in the culture media (FIG. 3b ). The ¹H NMR spectrum of the purified compound displayed two proton signals in the aromatic region (δH=8.19, 8.17), whereas six signals in DMSO-d5 (δH=12.74, 1H; 10.87; 0.7H; 9.50, 1H; 8.08, 1H; 7.75, 1H; 7.48, 0.4H) (FIG. 1c ). The gHMBC spectrum of purified compound revealed five carbon signals in the aromatic region (6C=113.60, 144.94, 148.17, 150.28, 150.45) (FIG. 10). These NMR chemical shifts suggested the presence of a purine moiety with an additional oxygen atom attached to one of the five nitrogen atoms. Given the chemical formula as C₅H₅N₅O, the structure was predicted as 6-N-hydroxyaminopurine (6-HAP). To confirm this predicted structure we performed a chemical synthesis of 6-HAP. The natural compound had an identical chemical shift to synthetic 6-HAP by ¹H-NMR (FIG. 3d ). In addition, the fragmentation profile of natural compound by electron-impact MS (FIG. 3e ) also matched that of synthetic product (FIG. 30. Most importantly, the antimicrobial activity of synthesized 6-HAP against GAS was comparable to that of natural product (FIG. 11). Thus, the combined data indicated that antimicrobial activity produced by this S. epidermidis strain is mediated by 6-HAP (FIG. 3g ).

Antimicrobial Activity of 6-HAP In Vitro.

To examine the specificity of 6-HAP for various bacteria, minimal bactericidal concentrations (MBCs) were determined according to dose-dependent killing curves at 24 hrs of incubation in vitro (Table 1). 6-HAP killed or suppressed growth of several major skin pathogens including GAS (NZ131), group B streptococcus (GBS) (DK23), methicillin-sensitive S. aureus (ATCC35556), methicillin-resistant S. aureus (MRSA) strains (USA300 and Sanger252), Pseudomonas aeruginosa (P. aeruginosa) (ATCC14213) in vitro. In contrast, 6-HAP showed weak antimicrobial activity against Staphylococcus hominis (S. hominis) (ATCC27844) and Escherichia coli (E. coli) (ATCC25922) and Propionibacterium acnes (ATCC6919). S. epidermidis (ATCC12228) was also resistant to 6-HAP.

TABLE 1 MBCs of 6-HAP against indicated bacterial strains. Bacteria Strain MBC (μg/mL)* GAS NZ131 0.156 GBS DK23 0.781 S. aureus ATCC35556 6.25 MRSA USA300 6.25 MRSA Sanger252 0.781 E. coli ATCC25922 50 P. aeruginosa ATCC14213 1.56 S. hominis ATCC27844 12.5 S. epidermidis ATCC12228 >50 P. acnes ATCC6919 >100 M. luteus ATCC4698 12.5 *MBCs were determined as a 3-log reduction of viable bacteria after 24 hour incubation at 37° C. in half strength of MHB in PBS. After incubation, live bacteria were measured by counting CFU after plating serial dilutions on agar plates. The data are representative of three independent experiments.

Antimetabolite Mechanism of Action of 6-HAP.

As 6-HAP is structurally similar to adenine, we hypothesized that it inhibited bacterial growth by a different mechanism than membrane permeation used by most other skin surface AMPs produced by the hose, or bacteriocins previously described from S. epidermidis ^(17,18). To examine this we first compared the kinetics of killing by 6-HAP to those by LL37, a potent human AMP with capacity to disrupt membranes, and mitomycin C, a known DNA synthesis inhibitor. Growth of GAS over time was inhibited by 6-HAP at a rate similar to mitomycin C but slower than LL37 (FIG. 4a ). LL37 disrupted permeability of the GAS membrane after 1-hr incubation, whereas 6-HAP and mitomycin C did not (FIG. 4b ). 6-HAP also did not directly affect plasma membrane permeability of normal human epidermal keratinocytes (NHEKs) or the human sebocyte line SZ95 after 6-hr incubation (FIG. 12).

We next assessed the effect of 6-HAP on DNA synthesis. Significant suppression of BrdU incorporation into the genomic DNA of GAS could be observed in a time-dependent manner (FIG. 4c ). However, 6-HAP did not affect BrdU incorporation in S. epidermidis (FIG. 4d ). To directly examine the action of 6-HAP on DNA extension in a cell free system, 25-bp templates and matching 18-bp fluorescence primers were designed to measure DNA extension in vitro by Klenow (exo⁻) DNA polymerase (FIG. 4e ). In the presence of 6-HAP, we observed synthesis of the expected extended DNA product when the template required cytosine (X=G), but lack of extension when adenosine was required (X=T) (FIG. 40. These data suggest that 6-HAP inhibits DNA synthesis by interfering with adenosine-thymidine base pairing. Indeed, addition of excessive adenine partially decreased antimicrobial activity of 6-HAP against GAS (FIG. 4g ).

Mechanism for Selective Antiproliferative Activity of 6-HAP.

Given the capacity to inhibit DNA synthesis, we next explored the anti-proliferative effects of 6-HAP on mammalian cells. 6-HAP inhibited BrdU incorporation in several tumor cell lines, including Pam212 squamous cell carcinoma (FIG. 5a ), B16F10 melanoma and L5178 and YAC-1 lymphoma (FIG. 13). In contrast, BrdU incorporation in normal human keratinocytes (NHEK) was not affected by 6-HAP until a very high dose (100 μg/mL) (FIG. 5b ). The mechanism of selective inhibition of mammalian cell lines, as well as selective inhibition of bacterial pathogens, is currently unknown and a subject of ongoing investigation.

Because some nucleobase analogs exert mutagenic activities due to their misrecognition of wrong bases, mutagenic activity of 6-HAP was determined by detecting mutagenic events at the thymidine kinase (tk) locus of L5178Y tk^(+/−) mouse lymphoma cells. This sensitive assay of mutagenic activity did not detect a difference between 6-HAP compared to vehicle, whereas treatment with methyl methanesulfonate was a positive control for the assay and did induce a high mutation frequency. These data are consistent with a lack of association between S. epidermidis and neoplastic transformation despite the chronic presence of this molecule as a product of the normal commensal microbiome.

In mammalian cells, mitochomdrial monoxide reducing components (mARC) 1 and 2 have shown to be capable of reducing N-hydroxylated nucleobase analogs to canonical nucleobases. Relative expression level of mARC1 and mARC2 was much higher in NHEKs than that in cancer cell lines, such as Pam212, L5178 and B16F10 (FIG. 5c ). Thus, we hypothesized that mARCs may contribute to detoxification of 6-HAP in NHEKs. Gene silencing with siRNA significantly decreased expression of mARC1 and mARC2 in NHEKs (FIG. 5d ) and increased cellular sensitivity to 6-HAP, suggesting that mARC2 protects cells from 6-HAP.

Effect of Systemic Administration with 6-HAP on Skin Infection and Melanoma Growth in Mice.

As 6-HAP exhibited both antimicrobial activity and antiproliferative activity in vitro, we next explored the systemic activities of this compound in vivo. Repeated intravenous injections of mice with 6-HAP at a dose of 20 mg/kg every 48 hrs for 2 weeks resulted in no apparent toxic effects as assessed by visual appearance, behavior or change in weight (FIG. 14). This response was consistent with prior results in seen in FIG. 4i demonstrating a lack of inhibition of the proliferation of rapidly dividing normal keratinocytes. Thus, given the apparent lack of toxicity, the effect on deep tissue infection was tested by intravenously injecting the non-toxic dose of 6-HAP (20 mg/kg) into a mouse model of GAS deep skin infection. A single injection of 6-HAP after inoculation of GAS significantly suppressed the clinical lesion size (FIG. 6a-b ) and GAS survival (FIG. 6c ) in mice.

Similar to our experiments to evaluate the antibiotic action of 6-HAP, we also examined the activity of 6-HAP to inhibit tumor growth in vivo. Mice were intradermally inoculated with B16F10 melanoma, followed by intravenous injection of 6-HAP (20 mg/kg) or vehicle every 48 hrs for 2 weeks. Tumor size of this aggressively growing tumor was suppressed by >60% in mice receiving 6-HAP compared to those received injections with vehicle (FIG. 6d-e ).

Effect of Skin Colonization by S. epidermidis on UV-Induced Skin Tumor Formation.

Given the data that 6-HAP inhibited the proliferation of several tumor lines in vitro and in vivo, we hypothesize that colonization by strains of S. epidermidis producing 6-HAP is protective against skin tumor formation induced by UV-B irradiation. To address this hypothesis, two-stage carcinogenesis model was employed. SKH-1 hairless mice were treated with DMBA for 1 week, followed by UV-B irradiation twice a week and epicutaneous application with S. epidermidis 6 times a week. Mice inoculated with S. epidermidis ATCC1457, a non-6-HAP strain, elicited 88% tumor incidence at 9 weeks (FIG. 7a ) and multiple tumor formations by 12 weeks (FIG. 7b-c ). In contrast, repeated application with S. epidermidis MO34 strain producing 6-HAP significantly decreased tumor incidence and numbers (FIG. 7a -b, d). Histopathogenic examination distinguished that SKH-1 mice colonized by control strain developed squamous papillomas (FIG. 7e ). The papilloma development was successfully inhibited by epicutaneous application with 6-HAP strain (FIG. 7 b, d, f). These data suggest that 6-HAP produced by S. epidermidis contributes to the resistance to neoplasm formation on the skin surface. In addition, both strains penetrate tumor and dermis of skin (FIG. 7g-h ), suggesting that the direct interaction between S. epidermidis and tumor cells or skin residing cells. This data is consistent with our previous observations that a part of skin microbiome can penetrate the epidermal barrier of human skin.

S. epidermidis Strains Producing 6-HAP in Human Skin.

6-HAP was detected by HPLC of culture supernatant from two distinct clinical isolates of S. epidermidis. To further explore the frequency of 6-HAP production in human commensal S. epidermidis stains, whole-genome sequencing of the MO34 strain was performed and used for analysis of existing metagenomic data sets of the human skin microbiome. Sequence analysis frequently identified S. epidermidis strains similar to the 6-HAP-producing isolate within the human skin microbiome but detected similar strains at a different frequency at distinct body sites.

TABLE 2 28 marker genes that are present in 6-HAP-producing S. epidermis strains but not in any of the other strains. Hypothetical gene ID Role Sequence peg.44# hypothetical SEQ ID NO: 1 protein atgagtgctgttttattatcagcaattagtccaacggcaagtgtaaatgaatcaataga attgtacaagtcagttagcaagtcgaatatagaaattgaaaaagataataagactttag atgattcgttttaa peg.45# hypothetical SEQ ID NO: 3 protein atgattcgttttaaaatcctaaatatggtaactgaacagactattaatagtttaccatata atcttaaagaagggacttcagaaagaattggtggttcctttactgtaaaaaaggattaa peg.131# YefM protein SEQ ID NO: 5 (antitoxin to atgactgttaaatcctattcatatgtacgtgaacatttcaaagacatgattaataaagtta YoeB) atgatgatagcgatacgataacaattacaacaaaagaccgtaatgcagttatgatgtc agaagataattataatgaaataatggagacactatacttgcaacaaaatcctgccaat gcaaaatatttatcagaatccattgaaaacctagaacgtggtaatataaaaactaagg atattttgatataa peg.139# antirepressor SEQ ID NO: 7 [Staphylococcus atgttagataaagaaaagcaaaaagaagctatgcctattattcaaggagagtacaaa epidermidis] tcagatgaaccaattaattacattaaagcaaacacaatcccaaacaaagctacatcaa cgacttttggatatgaaaagatgattagtaaagaggctatgacgccagaaatgttaga ggttcgtcaaataattcttaatgatgtggtaaagctcacagaatcaatgaatcaatttaa acttgatattaaagttagtaaagtaatttatgacaaatatggggtgagataa peg.140# antirepressor SEQ ID NO: 9 [Staphylococcus atgattaaacaaattttcaatgataaagaaattcggtttatcgaaaaagaagatgaatat epidermidis] tgggcagtagctggagatgtggcaaaggtattggggtactcacatacaccacacat gactagattattagatgaatcagaaaaggctgtccataatgtggtcaccgttaaaggt aaacaaaatgctgtgatcatattagaaataggtatttatgaagctatttggaatagtaga agagatgaagctcaagaattttag peg.141# XRE family SEQ ID NO: 11 transcriptional gtggttaacaacgttaaaagaatacgaaaaaataaaaaaattaccattactgaattaa regulator gtagaaaaagtgggataagcagaacaactatatacaaattagaatctcaaaaatcaa [Staphylococcus atcccagcttggaaaccattcaaaaaatatcttctggtttagatgaaaaaccagaaaa epidermidis] aatttttaacctcattgttattcaagaattacaaaaggagccttaa peg.142# XRE family SEQ ID NO: 13 transcriptional gtgaatgactttggaaagaaattaaaagaattaagaggcgaccaatcaattagagaa regulator gcctctaggaatattggtataagtcacacttatttagatagtttagaaaaaggtattgat [Staphylococcus ccaagaactggcaaagaaagaaaacctacaattgaagtaattcataaactatcaaaa epidermidis] tattataatgttgatttttttgatttaagcagattagcaggtgtgtttgtatcaattaaagat acgcctaaagaagataagcgagaagaaattaacaaaatgaagaaaagatttaaaga atattttaacgatacagaacttattgttaaagaaaattatcttgatattatgacaaaaaag ttaagttatcatgaaattattttttggcaaaatttatataatttttatattcaagaaaaagatt ctgattatctaaaaataaaagatgaagaagatacagatattttaacatttatagcttcctt gtttaaaatattaactgaaaataaaaattctaatgatgacgaaatatttaaaggcatttc gaatgattttaataaattcttaaaatcatacttaaatattaagtag peg.300# C4- SEQ ID NO: 15 dicarboxylate atgattaacactgccgtcactggtgctgaacctggaggtaactggaatccaaatatca ABC transporter tgataagctgcgctactatagcaaagatgccacatcccagtgcaccagcagttctta [Staphylococcus accctaataatatcgctagaatcatgattatgatttctatgataaacaataacatggaag epidermidis aatctcctaacttatgccgaacaattttcacttcaatattttatcactttaatatgtaa CIM28] peg.349# uncharacterized SEQ ID NO: 17 protein atgccggaagtttccggagaaatcgcttttaatttttcagcaattttagccgcagctata acaagtgataaagttgatgtaagtaagaaagcagatgcaattgtagttttggtgtcaa accagcgtctaatgtaa peg.372# MFS transporter SEQ ID NO: 19 [Staphylococcus atgccggcaccaatcgcttggataatccgagatatcattaaaatagaaaaagtaggt epidermidis] gaaactgctgctacaacagatcctataagaaaaattgccattgagaaaatatataaat ga peg.505# hypothetical SEQ ID NO: 21 protein ttgcctaagacacctgaagatgggaaaccaagtgtagataagaaaagctttgtaagt gaaactattttatttttatttatgtcgattctaggagaagtttttggctatgaagatgaaaa agatggacaacttgtacatgatatttctccaataaaaggacaagaaaaaaatatagaa aattctggttcagatgtgtttttctcttatcatgtagaagacgcaatacatccatataaac cagattatcttgctttatattgtttgaaatcggatcatgagaaaatagctataacagaga catcttctattagtgaagcaatgaaaagattaagtacgtcaacgcttaatattcttagaa aacccatgtatgaattacatccacctgcttcttttaattcaagtcatttatctagaaaagt atcagtaataggaggaagtcaaaagaatcctgaattattaattcatgaaacattaatgc aaggaatagaagatgaagcagaaaaagcattaagtgaattgaaagaaacgttaccg gaagtttcaaatggagttcaattaaacccaggagaacttattattttagataataataaa gcagcacatgctagatcagcttttaaacccagatatgacggtgaagatagatggcta caaagaatgttttctattaatgacttaaaaggattagaggattacatgaaagaagacg aaaatatatttgtacccttggtggatatattaaaagacaaataa peg.742# hypothetical SEQ ID NO: 23 protein atgaactttaaaacgaattttaaaggtttgtttagtatagaaaagaaatttaatgtaaattt attgccatctcaactcaaattagaagataaaataaacattttttgggcaacgttaatgag ggttgtaggctggcttttatatacattattaattgcaagtatgactgaagttaaaaataat aatattattatatacatatcatgtattttgatagtagtcttattaatatttgatataagttcaat ctttcttatttctgatgatatgagaaagaaaaattatagatatttgtttatcaaaagagac gaagaatattatcgtttagataaatatttttacgatatttctgataaacaagttttacaatat actgtaaatgaaaaagatatgaaaattgaaaaaaataatggcgatccaaaaattgatg agaaagaaaaaatagttggaaaaaagattgttactgaaaagataaatagtgataaag tcaatacatttatccaaactgatagcgaggctacatatagtagcaaatatattactttag tacctattgttcaaaacattatattgataataagtataatattaacagcttgttttcataaac tttggattgttatattatgtcttatcatatattttttgttaaatggaatatttacactacgattat catctaatgtaaatgaaactttagaaaataacaatataaagcaagttaaaaataaagtg aaaaatcattttaatgaagacgaaaatgataatgttggagataaaaaggatagctatg aacaccgtgataagaatatcaatattatcgttgttaatgaactaaaaaagtaa peg.743# terminase small SEQ ID NO: 25 subunit gtggctacaccagtgtttattgatagtgttggggaagaagatgaaaagaatgagaga [Staphylococcus gatttagaaaagttaagtaaactatatcctaatgcagagtttcacattgatgatattagg epidermidis] tag peg.1065# membrane SEQ ID NO: 27 protein atggctgttggattaccgcctgcaactgctttaggtacaaataaattagcgagttctttc [Staphylococcus ggatctcttacagctactatctcctttattagagcaaaaaaagtaaatattaaattgatg epidermidis] cctaaaatattcccttttgtttttcttgcttctattattggagcttatgttgcaactgtaattcc agcgcgatattttaaacctttggcgattataatgctttttatagtattgatttatacactcttt aaaaaggattggaacggtaatacactaataaacgaaacttctaaattaaaattatttatt gttttttccctactaatattaattggcttctatgatgggtttttaggtggaggaacaggta gtttctttatatttgttttattaattttaggattagactttttaaaatctgcaggaaatgctaa agttttaaattttggaagtaatataggtgccctgcttttatttatattattaaataaagtaga ttatttattaggtttcagtatggctttgtctatgattgttggaagctatattggtagttcattc gcagtaaaaaaaggtgtttcatatgtaaaattattatttataattgttactttacttttgttaa taaaaaacttatatgattatatatttcagtaa peg.1086# hypothetical SEQ ID NO: 29 protein atgaaattactagatgacaataattttgacttaaaactacctattaactataaaatcaata ctgataattatagatcacttactcaagataaattagatgcattaagttcatctgatgctaa ttttgatggtatttgggattag peg.1366# LysR family SEQ ID NO: 31 transcriptional atgaatcttttaatcagagaattggaaaatcattcaagagaagttggactcatagcata regulator taataaagaaatattgcaaaaagtatggagtattttaagtgaatacatagtgtaa [Staphylococcus epidermidis] peg.1369# ABC transporter SEQ ID NO: 33 permease ttgagagatccaagccaaacattattgattaaaaagttaaaaggtatatatttcaaggc [Staphylococcus ttttctaacttcatcaccatattctggaattaatggaactaaattagttgctataggtacg epidermidis] attaatataagaaaaaccccaattgaaaatactaaagaagaactttttactaataaagt aattagaaatagaaatagaccataa peg.1452# hypothetical SEQ ID NO: 35 protein atgaaaaagatgtggttaccaattataactacaatcatagtagctataattatagtatta atcattttaaaaaagacaaatcatttatattttaacaacttggatacatataaagtttataa agtggaagatagaaaagacatttctggtaagggtatcgtttttcctgaacatgttaaag tgtataaaattaataaaaatataggagaatatattagaccacaaattaaagattttagaa aagtgaaaaaaggtactccccttatttattatgatactaatagtagcaacaggcctaat ctagtggataatattaataacgttaaagaagatttaaatcgtgattatcaaaacgtagct aaacacaatagcagtagttatcaaaagcaaatatctaatgattaccaaaggttatttaa agctcaacaaaaattaaatcagcatgataatctgtctagtaaagatatatatgcagcttt taatggtgaagtgaaaattagtaattcaattagcggtaaaaatggtgacgaaattttaa aattagtttctacaaagtcagttattaagatgagagcttcacaatatatagttaataagat aaaaaaaggaagtaacgttaactttaaattagatagtgacagtgaaaatgtaaaaggt aaggtccagtctattgataacttacctataaatatgaaaaaagaacgttactataaaaa ctatgaacctaaatatatgattacaatttctgatttaaatcatggtgtgagagcaggattt actgggaaagtaacgattccttataatatgattgaaattcctcaaaatagtatcattaat aaaaattatgtttttatagttaataaggataattatgtacaaaaacgtagagttaaaatag taaagattaaaaataaactcattgctaagaaaggattaaaattaggtgatcgagtcatt gaaaaacctaaaagatctttacaagaaggacaacaaattaatattaaataa peg.1474# MULTISPECIES: SEQ ID NO: 37 pathogenicity gtgcaagaaactcattacgaatttaatatagatgatgaattaagaaaactaggtttatta island protein gttggaatatccgaagaaatgtactactgctcaattagtcgaatatcaacattgtatctt [Staphylococcus] gaaaactttggaactaaatgggtagcatggcgtgaaacttatgattttaagaatgataa aagagtatcgcacagaataatagcaaatggcagttttgaattagtagctgcaagaact aaaaactatttaaactacattaaaagaaagcagggaataaaatga peg.1475# DNA primase SEQ ID NO: 39 [Staphylococcus atgaaaatgtacaatgcagcaaagaatctccttagtaaagatgtgcaagttgtaccctt saccharolyticus] aaacgataataaaaagccaacagtatcatttaagaatataactattgatgatgattttat agataacaattttttagcatatgcaaagacaaatgtattaggtgtcctaactcgtggttt atggtgtatcgacattgatattaatcatgtaaatggtgaaagtggctttgatagtttgaa agacattccttactatgctgagtttgtttctaatgcacaaaatacgctagtgcagacaa cagcaagtgggggaaagcatgtaatatttaaaaaacgtgatggtgttgaatacgctc agaaaataggatatttaccatcagtagatattaaagcacatgataataactattttgtatt agctggaagtaaaacagctaaagggctatacactagtaataagaaaccagtaatca cttatgatggtgaatttgaagatcgcattttttcaaaacgtggaaattatctacaacaga ctatggaaaagttctcagtaaaaagcgtgttgcctaatcacaattttaatcatttacaac atactggcaaaggtggactaggtaaagaggcatacaatcgtgtaattaatggtgaaa gcatagaacgtaataatgatgtatataaagctattagttacgctttacaatgtaacgtgg atatagagcctctaaaagtaattattggtgatgttaaagcaaatggtgatgaatttacttt agaagagtgggaggcttcatataatagtgcaagaaactcattacgaatttaa peg.1476# phage resistance SEQ ID NO: 41 protein atggacgaagtttctttatataaaaaacattatcaattccattctaaattagataatgttga [Staphylococcus tacacctaatttatctcgtataaaagaaattagtaaaagaatttactttgctgcaattaca saccharolyticus] acagaaaaacaaatttttaataataaaggaagtgtttatcaccaaacaaaagatgaatt tgcaggtgattacattaataaccttactttagattataccataaaacctagagaaatagg tgcagtctatggaactatctctgttaaaacaacagtagagaacggtgaggagaataa agaggcacattttaagcctagtaaaacaaatagctatgcaaagttcattattgatctaat tactgaaaaagtcatctactcaaaagagttggatagctttatcaaattaaatagcaatc aatatgaaattatagataatactaatttttcattagagtatccggtagacaataagtatca tattaatgattttcttgatgtaatgctagaagtctacaaagagtatttcattaatgattatca atataatatttatccttacgctttcgcaggtaatgactggatatataattgcagaaaatta gaatttgtagataaaaaaattactagtaacgattactatatcatcaaatatgatgtagat aagaaaaatataaacactcaattagcacaaaaattttttgacttagtaagtgacaatga acgcagtaagaataatttaatgttggtacacgcttatactatgtatcgaaaaatgaaac ttattcaagcagaaaaatggttcttaatcaaagactttgggcgatctggtaaaggtttat ttatggaaacttttgaaaaacttctaaatgtaaacaaagtcaattttgatagcttattatca tctggctttgaggctgcaaatgaatggcttaacttttatggtgcagatattgctcatgca aatgaaacaggcgaaattaataaaggtatgatgagaatattacgcaaaatagctact ggtgagaatatttcagggcgtggcatacaacgaaataacgttaagtttaaaaataatg cagtattaattttagatactaatgaaagtgttgatactggtgaaattacagcaaatagaa cacgtacagttaaaatcgcatttaaggatagaccaaagaatgaaactgatgaagaac gttatcaagtatttaaaccattttgggactttgttaagcctaacgggaaaaactcagtca atgcgtcagtatcatttttaatattaagtcttgagtatcttaaacaaataggcagagaatt taagttcaataacgtaacacttaaaaactattacaccgaagatgaattgacggacact caaattcttatgctcaaagtcttagctaaacaagattttattttttcaggtgatgagatact acaaaaaactattgaagaagattataaaaatctgaaatataaaaaagcaaaagaaga tatgaaaaaaataggagtggctattaaccaacaggaatggatagagggacaaaaca ctaaagttcataaagtgaaaaatcaagaattatttaatatggctttagctttgattgaaac ttag peg.1542# hyperosmolarity SEQ ID NO: 43 resistance ttgcttgatgaagttgttattctatatttttcatttaatggttttatatttactgtaaacgaaac protein Emb aatactttcattcccacttttatctgtggctttaacttttacaattttatttgtgctattagttac [Staphylococcus attaggagcctga epidermidis] peg.1635# hypothetical SEQ ID NO: 45 protein atgaataaattaaataacaaagattataaaaatattgaaggcaaattgaattacgatca tatcgtaaatggcaaaaagcacattaaaaaaatgagcaaactattacaaaaacgtcg taacaaagatatttcaattattaaaaaaatgtacccttatttaaataataatgaaattttag aaatcactaatgattatcaagaatacaaaaatcttgttcaagctactgaaacttttacag actttcctagcatttacgaaggttctaatattagtaaattcttaactgaagatgatattgc agatttaaaaatggctgttgaagaaatgctagcttttgttgaaagattggaggagtag peg.1638# hypothetical SEQ ID NO: 47 protein atgctaaactttgagttaaagaaacacttaaaagataaagatatgactattagtgaatta agcgaaaaaactggaatatcaagaaattctttaggattattaataaatggaaaaagta gaggagttcaatttgaaacacttgaaaaaatttctagagttatgaatgtagatatcaaa aatttattttcaatgacttttgactttatagaaatatctgcaaaaaatgaaaaattacgtag ttctgaagtaggagttgattacaatgcgtcttatgattttaaacaattagtctgtaatatg aatatagatggaacagaatatgaattttctgttcaatatgaaatagatttacagttaaac atattaaaagatcatagttctgaagttaaaattactattgatttaagaaagtttaactacct aaatttatttttacccatcaattctgacgtagataatgaaatagcatatttaactcatgttta ttttatagacactatactcaaaatcaataaagatgaaattttagaattaatgggtaaagg tataaaaatatcttcaaatcaaatttcttatgtaataataaaagacgcttttcacattatttc atctggtattttatatatgaataatttcaagattacacaaaaagagttttatgttaataaac tcaaaactagtaatactataaattacatcgaagactccaataaaatactttttacaagca ggcataaaaatgttacataa peg.1640# hypothetical SEQ ID NO: 49 protein ttgtcgattttaattagttttcttagtttaattttatcaactttcgcttttttatatgcgaacaaa agacataagttgaatatgttagatcatttagatgataaatcagaatggagaaaaaaact atttgaaattgcaggttcttcaaaaattggaatgggaaatttatatcaatttagagctgc attaagattcacatacaaaaatgaagatgaatattatgaatataattattttgagtgcatg aacataattattataaaatattgtgaaaaattaataagtcaaaatcgaatagaagatcac aaacacaacgaaaacgaaaaggatcaatcttatttaaaaaattatgaaatggattcaa ttagattattttgtatttacatgttagcagatcattgggaaaaaaaacaaaacaaaaattt taaatttaacaatccagtaaaagaagtagaattatgtatagacaccttacaaaaatttct caatattaatgataaaaactattgttataaatgccataaaagtaaattaaatagagataa tttttactgtttgtatcaccaaagtataagtttgataaattctatgacatcctaa peg.1975# ABC transporter SEQ ID NO: 51 ATP-binding atgggctgtacgactgctgatattttagcctgttttaatcctaatctatatatttttttaagat protein ttgtatgcgcattatctaactctaaacgctcagtattagatactttaactaaacgcatttc [Staphylococcus ggtaagcactctacctaataatccactgaagttcgcaatttcagattgcgtattggtag epidermidis] atattttttgcatcacacgtcccagaggaacgatgattaaaataaatacaggaatagta ataaatgttaataaagttaatttccaatccatgataaatagcatgactaatgaacctact aacgttaaaacagaaggcaataaattaggtagcttttgtgaaataaattcattaatcact tttgtatcatctgttagacgactcattaattggccactttcatttttatcaaagaacggcat ttttaattga peg.2217# hypothetical SEQ ID NO: 53 protein atgattctatggaagaaatatgggagctatgaaatgcaaattgcatttaaagatttcaat gaagataagcaaactattaatgagtatactcattttttagttcagaaagaactacattga peg.2226# hypothetical SEQ ID NO: 55 protein atggatgattataactctaataatgatacgaatgattggcatgaaatcattgaacagct gaagaacgataacgagatactcaaatctaacaatcaagaacttcagcaacatattcat cagctggaagacgagatagacccaatgagacaagaaaatgatgtttttcatcatttat tacaacattttgatagtacagcatttatgaacttcaatacatatcgtgatgatcgcccatt aaaaaatgcgattaaacgattgaaagaacaataa

A number of embodiments of the invention have been described. Nevertheless, it will be understood that various modifications may be made without departing from the spirit and scope of the invention. Accordingly, other embodiments are within the scope of the following claims. 

What is claimed is:
 1. A method for inhibiting the growth, migration, proliferation and/or metastasis of a pre-cancer, cancer or neoplastic cell or inhibiting a pathogen, wherein the pre-cancer, cancer or neoplastic cell is selected from the group consisting of melanoma, squamous cell carcinoma, actinic keratosis, keratoacanthoma, and basal cell carcinoma, comprising contacting the cell or pathogen with an inhibiting effective amount of a composition comprising a compound of Formula I(a):

or a pharmaceutically acceptable salt or thereof, wherein, N¹—N⁵ are nitrogen atoms; X¹-X² are carbon atoms; the R groups attached by a dashed line are present, or are not present if the R group is connected to an atom that is bound to another atom by a double covalent bond; the bond indicated by both a straight line and a dashed line indicate that the bond may be a single covalent bond or a double covalent bond; the fused heterocyclic ring system comprises three double bonds with N² or N³ forming a double bond and with X¹, and with N⁴ or N⁵ forming a double bond with X²; R¹ is a hydroxyl; and R², R³, R⁴, R⁵, R⁶, R⁷, R⁸, and R⁹ are independently a H, D, or optionally substituted (C₁-C₃)-alkyl.
 2. The method of claim 1, wherein the cancer cell is contacted in vivo.
 3. The method of claim 1, wherein the contacting is through topical administration.
 4. The method of claim 1, wherein the composition further comprises a chemotherapeutic agent.
 5. The method of claim 1, wherein the composition is formulated for topical administration.
 6. The method of claim 1, wherein the composition is formulated for systemic administration.
 7. The method of claim 1, wherein the composition comprises a commensal probiotic bacteria that produces the compound of Formula I(a), I(b) or II.
 8. The method of claim 7, wherein the commensal probiotic bacteria expresses 1 or more of the sequences set forth in SEQ ID Nos: 1, 3, 5, 7, 9, 11, 13, 15, 17, 19, 21, 23, 25, 27, 29, 31, 33, 35, 37, 39, 41, 43, 45, 47, 49, 51, 53, and/or
 55. 9. The method of claim 7, wherein the commensal probiotic bacteria comprises S. epidermidis strain MO34 and/or MO38. 